Nocardia brasiliensis endophthalmitis in a patient with an exposed Ahmed glaucoma drainage implant

To report a case of endophthalmitis due to Nocardia brasiliensis in an eye with an exposed, infected Ahmed glaucoma drainage implant (GDI).

Retrospective case report.

A patient with an exposed GDI experienced recurrent episodes of endophthalmitis despite repeated intravitreal injections of antibiotics and steroids. The tube was initially repositioned and finally removed.

Whereas repeated cultures from the anterior chamber and vitreous were negative, cultures from the removed tube grew Nocardia brasiliensis. Despite oral trimethoprim-sulfamethoxazole and intravitreal amikacin the eye became phthisical and lost light perception.

An exposed GDI may lead to endophthalmitis due to Nocardia brasiliensis and may require explantation to establish a diagnosis.