Journal of vitreoretinal diseases · 2026
Clinical Features, Antimicrobial Susceptibilities, and Outcomes of Acute-Onset Exogenous Nocardia Endophthalmitis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Zhao Michael Y, Yuan Zhuochen, Oh Jin Kyun, Miller Darlene, Flynn Harry W
Аннотация
PURPOSE: To describe the clinical features, antimicrobial susceptibilities, and treatment outcomes of acute-onset exogenous Nocardia endophthalmitis following non-cataract surgery.
METHODS: Two cases were retrospectively reviewed.
RESULTS: Two patients developed acute-onset exogenous endophthalmitis following non-cataract procedures and subsequently underwent multiple surgical interventions. The first patient developed a fulminant infection in the left eye following revision of a glaucoma drainage implant and ultimately progressed to no-light-perception vision, undergoing enucleation. The second patient developed endophthalmitis secondary to infectious scleritis in the right eye and had a best-corrected visual acuity of 5/200 at last follow-up. Microbiologic analysis identified Nocardia brasiliensis and Nocardia niwae. Both isolates demonstrated susceptibility to amikacin and sulfamethoxazole/trimethoprim, with variable susceptibility to β-lactams and fluoroquinolones.
CONCLUSIONS: Acute-onset exogenous Nocardia endophthalmitis may occur after a variety of ophthalmologic procedures and is associated with a poor visual prognosis despite surgical intervention and targeted antimicrobial therapy. Amikacin and sulfamethoxazole/trimethoprim remain the preferred antimicrobial agents.
METHODS: Two cases were retrospectively reviewed.
RESULTS: Two patients developed acute-onset exogenous endophthalmitis following non-cataract procedures and subsequently underwent multiple surgical interventions. The first patient developed a fulminant infection in the left eye following revision of a glaucoma drainage implant and ultimately progressed to no-light-perception vision, undergoing enucleation. The second patient developed endophthalmitis secondary to infectious scleritis in the right eye and had a best-corrected visual acuity of 5/200 at last follow-up. Microbiologic analysis identified Nocardia brasiliensis and Nocardia niwae. Both isolates demonstrated susceptibility to amikacin and sulfamethoxazole/trimethoprim, with variable susceptibility to β-lactams and fluoroquinolones.
CONCLUSIONS: Acute-onset exogenous Nocardia endophthalmitis may occur after a variety of ophthalmologic procedures and is associated with a poor visual prognosis despite surgical intervention and targeted antimicrobial therapy. Amikacin and sulfamethoxazole/trimethoprim remain the preferred antimicrobial agents.