1887

JMM Case Reports

Volume 6, Issue 2

Post-traumatic endophthalmitis caused by Nocardia nova Open Access

Abstract

Introduction. Nocardia nova complex has been associated with infections in both immunocompetent and immunocompromised patients. Infection can be localized or disseminated, affecting skin and soft tissues, the respiratory system, bones and joints, the circulatory system and especially the central nervous system. Ocular infections such as keratitis, scleritis, conjunctivitis, dacryocystitis, orbital cellulitis and endophthalmitis due to Nocardia spp. are infrequently reported, and usually described after penetrating corneal trauma or ocular contact with plants and soils.

Case presentation. An immunocompetent male presented with a history of penetrating ocular trauma that had evolved to infectious endophthalmitis, which was refractory to different antibiotic treatments. No micro-organisms were isolated from repeated conjunctival smear and corneal scraping cultures between the ocular trauma (August 2014) and the endophthalmitis diagnosis (November 2015). After this period, N. nova sensu stricto was isolated in aqueous humour aspirate. Treatment was adjusted and clinical improvement was obtained after an adequate microbiological procedure, including an optimal sampling and an antimicrobial-susceptibility testing report.

Conclusion. Nocardia identification to the species level and performance of antimicrobial-susceptibility tests are both essential tools for treatment adjustment and clinical improvement.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): endophthalmitis , Nocardia , Nocardia nova complex , Nocardia nova sensu stricto and ocular nocardiosis
© 2019 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.005175
2019-02-20
2024-04-16
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/6/2/jmmcr005175.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.005175&mimeType=html&fmt=ahah

References

  1. Muñoz J, Mirelis B, Aragón LM, Gutiérrez N, Sánchez F et al. Clinical and microbiological features of nocardiosis 1997-2003. J Med Microbiol 2007; 56:545–550 [View Article][PubMed]
     [Google Scholar]
  2. Rudramurthy SM, Honnavar P, Kaur H, Samanta P, Ray P et al. Molecular identification of clinical Nocardia isolates from India. J Med Microbiol 2015; 64:1216–1225 [View Article][PubMed]
     [Google Scholar]
  3. Ambaye A, Kohner PC, Wollan PC, Roberts KL, Roberts GD et al. Comparison of agar dilution, broth microdilution, disk diffusion, E-test, and BACTEC radiometric methods for antimicrobial susceptibility testing of clinical isolates of the Nocardia asteroides complex. J Clin Microbiol 1997; 35:847–852[PubMed]
     [Google Scholar]
  4. CLSI Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes; Approved Standard, 2nd edn, document M24-A2. Wayne, PA: Clinical and Laboratory Standard Institute; 2011
     [Google Scholar]
  5. Valdezate S, Garrido N, Carrasco G, Medina-Pascual MJ, Villalón P et al. Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain. J Antimicrob Chemother 2017; 72:754–761 [View Article][PubMed]
     [Google Scholar]
  6. Kim YK, Oh J-R, Choi HK, Kim HY, Park SD et al. Primary cutaneous nocardiosis caused by Nocardia nova in a kidney transplant recipient. J Med Microbiol 2014; 63:140–143 [View Article]
     [Google Scholar]
  7. Khan BA, Duncan M, Reynolds J, Wilkes DS. Nocardia infection in lung transplant recipients. Clin Transplant 2008; 22:562–566 [View Article][PubMed]
     [Google Scholar]
  8. Laurent F, Rodriguez-Villalobos H, Cornu O, Vandercam B, Yombi JC. Nocardia prosthetic knee infection successfully treated by one-stage exchange: case report and review. Acta Clin Belg 2015; 70:287–290 [View Article][PubMed]
     [Google Scholar]
  9. Al Akhrass F, Hachem R, Mohamed JA, Tarrand J, Kontoyiannis DP et al. Central venous catheter-associated Nocardia bacteremia in cancer patients. Emerg Infect Dis 2011; 17:1651–1658 [View Article][PubMed]
     [Google Scholar]
  10. Minero MV, Marín M, Cercenado E, Rabadán PM, Bouza E et al. Nocardiosis at the turn of the century. Medicine 2009; 88:250–261 [View Article][PubMed]
     [Google Scholar]
  11. Micheletti JM, Agrawal M, Matoba AY, Marx DP. Chronic conjunctivitis due to Nocardia nova complex formation on a silicone stent: a case report and review of the literature. Ophthalmic Plast Reconstr Surg 2015; 31:131–132 [View Article][PubMed]
     [Google Scholar]
  12. DeCroos FC, Garg P, Reddy AK, Sharma A, Krishnaiah S et al. Optimizing diagnosis and management of nocardia keratitis, scleritis, and endophthalmitis: 11-year microbial and clinical overview. Ophthalmology 2011; 118:1193–1200 [View Article][PubMed]
     [Google Scholar]
  13. Garg P. Fungal, mycobacterial, and nocardia infections and the eye: an update. Eye 2012; 26:245–251 [View Article][PubMed]
     [Google Scholar]
  14. Brown-Elliott BA, Brown JM, Conville PS, Wallace RJ. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev 2006; 19:259–282 [View Article][PubMed]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.005175
Loading
Post-traumatic endophthalmitis caused by Nocardia nova
JMM Case Rep 6, e005175 (2019); https://doi.org/10.1099/jmmcr.0.005175
/content/journal/jmmcr/10.1099/jmmcr.0.005175
/content/journal/jmmcr/10.1099/jmmcr.0.005175
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error