Nocardia choroidal ABSCESS: Risk factors, treatment strategies, and visual outcomes

Ruwan A. Silva, Ryan Young, Jay Sridhar, Harry W Flynn

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: To describe the risk factors, clinical course, ancillary test findings, treatment strategies, and visual outcomes of a series of patients with choroidal abscesses caused by endogenous Nocardia. Methods: This retrospective, consecutive noncomparative case series included all patients with Nocardia ocular infections at 3 tertiary medical centers over the past 20 years. Results: Five eyes in 5 patients were identified with choroidal abscesses because of Nocardia. All patients were immunocompromised: one suffered from AIDS and four had autoimmune disorders. Three of the 5 patients (60%) underwent systemic evaluation, and in all 3, nonocular nocardiosis was identified. Four patients (80%) underwent diagnostic ophthalmic surgery and received systemic and intravitreal antibiotics. The final patient deferred these interventions. Outcomes at the last follow-up examination were 20/25, 1/200, hand motion at 1 foot, and 2 patients underwent enucleation. Mean follow-up (±standard deviation) was 159 (±103) days. Conclusion: Immunosuppression is the most significant risk factor for developing Nocardia choroidal abscesses. Definitive diagnosis generally requires subretinal biopsy, which is also critical to implementing appropriate antibiotic therapy.

Original languageEnglish (US)
Pages (from-to)2137-2146
Number of pages10
JournalRetina
Volume35
Issue number10
StatePublished - Oct 1 2015
Externally publishedYes

Fingerprint

Nocardia
Nocardia Infections
Abscess
Therapeutics
Anti-Bacterial Agents
Eye Infections
Immunocompromised Host
Immunosuppression
Acquired Immunodeficiency Syndrome
Hand
Biopsy

Keywords

  • choroidal abscess
  • endophthalmitis
  • Nocardia.

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Nocardia choroidal ABSCESS : Risk factors, treatment strategies, and visual outcomes. / Silva, Ruwan A.; Young, Ryan; Sridhar, Jay; Flynn, Harry W.

In: Retina, Vol. 35, No. 10, 01.10.2015, p. 2137-2146.

Research output: Contribution to journalArticle

Silva, RA, Young, R, Sridhar, J & Flynn, HW 2015, 'Nocardia choroidal ABSCESS: Risk factors, treatment strategies, and visual outcomes', Retina, vol. 35, no. 10, pp. 2137-2146.
Silva, Ruwan A. ; Young, Ryan ; Sridhar, Jay ; Flynn, Harry W. / Nocardia choroidal ABSCESS : Risk factors, treatment strategies, and visual outcomes. In: Retina. 2015 ; Vol. 35, No. 10. pp. 2137-2146.
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