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Nocardia infection following ocular surface surgery
Jingting Wang1,2,3, Xiuhai Lu1,2,3, Jungang Wang1,2,3
1Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, No. 372, Jingsi Road, Huaiyin District, Jinan, China.
International Ophthalmology
|September 14, 2022
Summary
Ocular Nocardia infection can occur after eye surgery. Prompt surgical removal of infected tissue is crucial for managing Nocardia infection, as medical treatments are often ineffective.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Ocular surface surgery can predispose patients to secondary infections.
- Nocardia species are opportunistic pathogens that can cause severe infections.
Purpose of the Study:
- To investigate the clinical characteristics of Nocardia infection following ocular surface surgery.
- To evaluate the treatment outcomes for these infections.
Main Methods:
- Retrospective study of eight culture-proven Nocardia infection cases.
- Analysis of patient demographics, clinical history, and surgical procedures.
- Review of treatment strategies and outcomes.
Main Results:
- Nocardia infection occurred within one month post-surgery in patients aged 27-65.
- Common procedures included pterygium excision, conjunctival flap covering, and lamellar keratoplasty.
- Infections presented as infiltrates at surgical sites, corneal, or conjunctival ulcers.
- Medical therapy was largely ineffective; reoperation was required in seven cases.
- Recurrence was noted in three cases post-reoperation, with one eye requiring evisceration.
Conclusions:
- Surgical trauma is a significant risk factor for ocular Nocardia infection.
- Atypical presentations of secondary infections post-surgery warrant suspicion for Nocardia.
- Corticosteroid use may impact treatment efficacy.
- Complete surgical debridement is vital for reducing recurrence, especially with poor response to medical treatment.
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