{"title":"<i>Nocardia</i> keratitis: A clinical diagnosis with successful outcome.","authors":"Dubbaka Srujana, Sandeep Shankar, Kavita Bala Anand, Mohini Agrawal, Aanchal Singhal, Ashok Kumar, Divya Kochhar","doi":"10.4103/ojo.ojo_175_23","DOIUrl":null,"url":null,"abstract":"<p><p><i>Nocardia</i> keratitis is mostly seen in patients with alcoholism, malnutrition, or HIV. Its chronic waxing-and-waning course makes it difficult to diagnose. A 53-year-old male presented with pain and redness in his right eye for the past 3 weeks. The cornea had paracentral ulcer with stromal infiltrates and multiple satellite lesions giving wreath-like appearance suggestive of <i>Nocardia</i>. After corneal scraping, fortified amikacin, moxifloxacin, and cycloplegics were started. Gram stain revealed filamentous, branching Gram-positive bacteria and acid-fast on Ziehl-Neelsen stain confirming our clinical diagnosis. Ulcer completely resolved over 6 weeks. Thus, a high index of clinical suspicion which was further backed by microbiological confirmation aided in expedient management ensuring a successful outcome.</p>","PeriodicalId":19461,"journal":{"name":"Oman Journal of Ophthalmology","volume":"17 2","pages":"261-263"},"PeriodicalIF":0.0000,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309550/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oman Journal of Ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ojo.ojo_175_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Nocardia keratitis is mostly seen in patients with alcoholism, malnutrition, or HIV. Its chronic waxing-and-waning course makes it difficult to diagnose. A 53-year-old male presented with pain and redness in his right eye for the past 3 weeks. The cornea had paracentral ulcer with stromal infiltrates and multiple satellite lesions giving wreath-like appearance suggestive of Nocardia. After corneal scraping, fortified amikacin, moxifloxacin, and cycloplegics were started. Gram stain revealed filamentous, branching Gram-positive bacteria and acid-fast on Ziehl-Neelsen stain confirming our clinical diagnosis. Ulcer completely resolved over 6 weeks. Thus, a high index of clinical suspicion which was further backed by microbiological confirmation aided in expedient management ensuring a successful outcome.
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