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Bilateral intraocular Nocardia asteroides infection.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|August 1, 1977
Summary
A patient with hypogammaglobulinemia experienced a disseminated Nocardia asteroides infection, which spread to the eyes, causing a new metastatic lesion in the previously unaffected eye before death.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Hypogammaglobulinemia compromises immune function, increasing susceptibility to opportunistic infections.
- Nocardia asteroides is an opportunistic pathogen that can cause severe disseminated disease.
Observation:
- A 38-year-old male with hypogammaglobulinemia presented with pulmonary Nocardia asteroides infection.
- The infection subsequently spread to the eyes, manifesting as intraocular Nocardia infection confirmed via pars plana vitrectomy.
Findings:
- Initial intraocular infection showed partial resolution of the chorioretinal lesion.
- A new, rapidly progressing metastatic nocardial chorioretinal lesion developed in the previously uninvolved eye.
- Postmortem examination confirmed the presence of Nocardia asteroides in the metastatic ocular lesion.
Implications:
- Ocular involvement is a serious complication of disseminated Nocardia asteroides infection, particularly in immunocompromised individuals.
- Metastatic spread to the contralateral eye can occur even after initial treatment or partial resolution.
- This case highlights the aggressive nature of Nocardia infections and the importance of vigilant monitoring for metastatic disease in at-risk patients.