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Nocardia Subretinal Abscess: A Rare and Challenging Case Report
Ana Maria Cunha1, Marta Silva1, Ana Catarina Pedrosa1
1Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal.
Prompt diagnosis and treatment of submacular Nocardia abscess led to rapid visual improvement. Early intervention is key for subretinal inflammatory lesions.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Submacular Nocardia abscess is a rare cause of visual decline.
- Systemic nocardiosis can present with ocular manifestations.
Observation:
- A 50-year-old male presented with painless visual decline in the left eye.
- Ocular examination revealed a submacular white mass and an inferior temporal lesion.
- The patient had a history of systemic nocardiosis diagnosed four years prior.
Findings:
- Treatment involved systemic antibiotics (SMX-TMP, imipenem) and intravitreal bevacizumab.
- This regimen resulted in rapid resolution of the submacular abscess.
- Significant improvement in visual acuity was observed post-treatment.
Implications:
- A high index of suspicion is crucial for diagnosing subretinal inflammatory lesions.
- Prompt and targeted treatment can lead to favorable visual outcomes.
- This case highlights the importance of considering Nocardia in subretinal infections.
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