Post-traumatic endophthalmitis caused by Nocardia nova

Nocardia species can cause infections in immunocompetent and immunocompromised patients, usually by inhalation from environmental sources, and lung disease is the most reported clinical form [1]. We present a clinical case of endophthalmitis by Nocardia nova sensu stricto in an
immunocompetent male with a history of penetrating ocular trauma more than a year before. We argue that it is possible that the Nocardia micro-organism was present in superficial ocular lesions, before the endophthalmitis manifested a year later, and so its presence was not detected in
the microbiological culture of the superficial samples (ocular smears and corneal scrapings) due to the short period of incubation, the presence of mixed flora, the previous use of antibiotics or an inadequate sample collection. By presenting this case, we want to reinforce the importance of a good communication between clinical practitioners and microbiological staff to obtain an adequate sample and the most precise diagnosis. Moreover, as we confirm with this clinical picture, treatment of Nocardia infections should be individualized, so correct identification and antimicrobial-susceptibility testing are critical [1]. Recent incorporation of more advanced identification methods offers an opportunity for rapid and correct identification at the species level [2], which favours a more adequate therapy.

Categories : Microbiology

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