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Nocardia choroidal abscess.

W B Phillips1, C L Shields, J A Shields

  • 1Wills Eye Hospital, Philadelphia, PA 19107.

The British Journal of Ophthalmology
|November 11, 1992
PubMed
Summary
This summary is machine-generated.

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Nocardia asteroides, a rare bacterial cause of infection, was identified in a patient with chronic lymphocytic leukemia. This diagnosis led to early antibiotic treatment for ocular, central nervous system, and joint nocardial infections.

Area of Science:

  • Medical Microbiology
  • Ophthalmology
  • Infectious Diseases

Background:

  • Nocardia species are Gram-positive, aerobic bacteria known for causing opportunistic infections, primarily in immunocompromised individuals.
  • Nocardia infections typically manifest as subcutaneous abscesses or pneumonia, with ocular involvement being exceedingly rare.

Observation:

  • A patient with chronic lymphocytic leukemia (CLL) on immunosuppressive therapy presented with painless vision loss in the right eye.
  • The patient also experienced refractory shoulder pain and recurrent episodes of pneumonia, suggesting a disseminated infection.

Findings:

  • A transvitreal fine-needle aspiration biopsy of the choroidal lesion confirmed Nocardia asteroides as the causative agent.
  • Subsequent systemic work-up revealed concurrent central nervous system and arthritic Nocardia infections.

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Implications:

  • This case highlights the importance of considering Nocardia in immunocompromised patients with atypical presentations, including ocular symptoms.
  • Early diagnosis and targeted antibiotic therapy are crucial for managing disseminated Nocardia infections and preventing severe complications.
  • Ocular Nocardia infection can be a presenting sign of systemic disease in immunocompromised hosts.