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Nocardia arthritidis scleritis: A case report.
Omar Abdelmegid1, Shambhawi Thakur2, Albert Y Cheung2,3
1University of Massachusetts Medical School, Department of Ophthalmology, Worcester, MA, USA.
American Journal of Ophthalmology Case Reports
|January 23, 2023
Summary
Infectious scleritis caused by Nocardia arthritidis was successfully treated in an immunocompromised patient post-cataract surgery. Prompt diagnosis and a combination of subconjunctival injections and oral antibiotics led to a full recovery.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Infectious scleritis is a serious ocular condition that can lead to vision loss if not treated promptly.
- Nocardia species are uncommon causes of infectious scleritis, particularly in immunocompromised patients.
Observation:
- A 69-year-old female with a history of renal transplantation presented with severe ocular pain and an abscess following cataract surgery.
- Examination revealed scleral thickening, multiloculated abscesses, and purulent drainage.
- Cultures confirmed the presence of Nocardia arthritidis.
Findings:
- The patient was treated with debridement, subconjunctival antibiotic injections, topical antifungals, and oral trimethoprim-sulfamethoxazole.
- The patient responded well to treatment, with complete resolution of the scleritis.
- No recurrence of disease was noted at 12-month follow-up.
Implications:
- This case highlights Nocardia arthritidis as a cause of infectious scleritis.
- Successful treatment was achieved using strategies similar to those for other Nocardia species.
- Nocardia scleritis should be considered in immunocompromised patients with acute ocular symptoms after surgery.
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