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Nocardia keratitis: a case report
S Matuska1, P Rama, A Cavallero
1Department of Ophthalmology and Visual Sciences, University Hospital San Raffaele, Milano, Italy.
European Journal of Ophthalmology
|February 24, 2006
Summary
Nocardia keratitis resistant to amikacin can occur. Topical corticosteroids may trigger infection relapse, necessitating prolonged antibiotic treatment with combination therapy.
Area of Science:
- Ophthalmology
- Medical Microbiology
Background:
- Nocardia keratitis is a serious ocular infection.
- Prompt diagnosis and appropriate antimicrobial therapy are crucial for successful treatment.
Observation:
- A case of Nocardia keratitis resistant to 2% amikacin was observed.
- Fortified topical 5% amikacin led to a toxic-allergic reaction.
- Recurrence of infection occurred after topical corticosteroid use.
Findings:
- Nocardia asteroides was identified as the causative agent.
- A combination of chloramphenicol, tetracycline, colistin, and ofloxacin proved effective.
- Prolonged treatment (3 months) was required for resolution.
Implications:
- Topical amikacin may exhibit resistance in Nocardia keratitis cases.
- Topical corticosteroids should be used cautiously due to potential for relapse.
- Combination antibiotic therapy is a viable treatment option for resistant Nocardia keratitis.
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