Acute post-operative panophthalmitis by Nocardia otitidiscaviarum: A rare presentation

Nocardia species are infrequently associated with ocular conditions, such as keratitis, dacryocystitis, endophthalmitis, and orbital cellulitis, particularly related to ocular trauma involving vegetative matter. Their incidence in acute-onset post-operative endophthalmitis is rarely documented. We discuss a 65-year-old diabetic female patient who presented with acute-onset vision loss, with corneal perforation and panophthalmitis two weeks following cataract surgery. Evisceration had to be performed. The culture of ocular contents revealed the presence of Nocardia otitidiscaviarum, identified by MALDI-TOF MS. The case highlights the importance of microbiological diagnostics and antimicrobial susceptibility testing, coupled with early intervention in the management of acute-onset post-cataract surgery panophthalmitis.