Endogenous nocardial chorioretinitis in an immunocompetent patient.

PURPOSE: To describe the presentation and management of an immunocompetent patient with endogenous Nocardia chorioretinitis.

METHODS

A previously healthy 55-year-old woman presented with reduced vision and metamorphopsia after accidental inhalation of Nocardia organisms from planting soil. She developed systemic nocardiosis with pulmonary and cerebellar involvement as well as bilateral chorioretinitis. Ocular infection resulted in choroidal neovascularization, which was successfully treated with intravitreal triamcinolone and thermal laser photocoagulation.

DISCUSSION: This patient is one of only a few immunocompetent individuals to develop endogenous nocardial chorioretinitis. Systemic antibiotic treatment and local laser therapy for subsequent choroidal neovascularization were effective in management of this case.