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CASE REPORT
Year : 2017  |  Volume : 12  |  Issue : 1  |  Page : 113-116

Endogenous nocardial endophthalmitis in an immunosuppressed patient: A serious warning of an underlying life threatening and blinding disorder


1 Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India
2 Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment; Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India

Correspondence Address:
Jaya Kaushik
Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2008-322X.200172

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Purpose: To report a case of bilateral endogenous nocardial endophthalmitis with central nervous system involvement in an immunocompromised individual with an extremely poor outcome. Case Report: A 35-year-old man with a history of long-term, prescribed oral steroid use for membranoproliferative glomerulonephritis presented with profound bilateral vision loss. Patient's diagnosis of bilateral endogenous nocardial endophthalmitis was delayed. Nocardia was finally isolated from a brain biopsy after a repeat magnetic resonance imaging revealed a brain abscess. With anti-nocardia therapy, patient improved systemically, but the visual outcome was poor, with no light perception in both eyes. Conclusion: Ocular nocardiosis is a serious vision and life threatening disorder, particularly in patients on immunosuppressive therapy. A high index of suspicion is required for successful treatment.


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