Exogenous Nocardia asteroides endophthalmitis associated with malignant glaucoma

A 42-year-old man sustained a penetrating corneal wound with a soil-contaminated wire and developed Nocardia asteroides endophthalmitis. A month delay in diagnosis occurred while topical and systemic steroids were prescribed for persistent anterior uveitis, but the diagnosis was finally established by separate aqueous and vitreous aspirates. The patient's course was complicated by a form of malignant glaucoma that was relieved by vitreous aspiration and reformation of the anterior chamber. Surgical intervention, followed by intensive topical and systemic sulfonamide therapy, has resulted in potential visual improvement.