Postoperative Nocardia Endophthalmitis and the Challenge of Managing with Intravitreal Amikacin

Nocardia is a rare cause of delayed onset postoperative endophthalmitis after cataract surgery and it usually carries a guarded visual prognosis. Purpose. To highlight the clinical presentation, microbiological profile, and treatment outcome in a case of nocardial endophthalmitis after manual small...

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Main Authors: Sikander A. K. Lodhi, G. Ashok Kumar Reddy, C. Aruna Sunder
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2016/2365945
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author Sikander A. K. Lodhi
G. Ashok Kumar Reddy
C. Aruna Sunder
author_facet Sikander A. K. Lodhi
G. Ashok Kumar Reddy
C. Aruna Sunder
author_sort Sikander A. K. Lodhi
collection DOAJ
description Nocardia is a rare cause of delayed onset postoperative endophthalmitis after cataract surgery and it usually carries a guarded visual prognosis. Purpose. To highlight the clinical presentation, microbiological profile, and treatment outcome in a case of nocardial endophthalmitis after manual small incision cataract surgery. Methods. This case report highlights the typical features of Nocardia endophthalmitis, which presented six weeks after undergoing small incision cataract surgery. The case was managed by pars plana vitrectomy with intravitreal antibiotics. Intravitreal amikacin was used based on microbiologic work-up. Results. The endophthalmitis part was controlled but the case developed amikacin induced macular infarction which jeopardized a good visual outcome. Conclusion. Nocardia endophthalmitis manifests late after cataract surgery in an aggressive manner and carries a poor visual prognosis. An early diagnosis and the use of correct antibiotic regimen may salvage the vision. But the present case shows that one should always be wary of potential retinal toxicity with intravitreal amikacin.
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spelling doaj-art-770d9be6c5ff462bb0fa7f97cff996c62025-08-20T02:07:35ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302016-01-01201610.1155/2016/23659452365945Postoperative Nocardia Endophthalmitis and the Challenge of Managing with Intravitreal AmikacinSikander A. K. Lodhi0G. Ashok Kumar Reddy1C. Aruna Sunder2Sarojini Devi Eye Hospital, Hyderabad 500028, IndiaGHR Micro Diagnostics, Dwarakapuri Colony, Hyderabad 500082, IndiaSarojini Devi Eye Hospital, Hyderabad 500028, IndiaNocardia is a rare cause of delayed onset postoperative endophthalmitis after cataract surgery and it usually carries a guarded visual prognosis. Purpose. To highlight the clinical presentation, microbiological profile, and treatment outcome in a case of nocardial endophthalmitis after manual small incision cataract surgery. Methods. This case report highlights the typical features of Nocardia endophthalmitis, which presented six weeks after undergoing small incision cataract surgery. The case was managed by pars plana vitrectomy with intravitreal antibiotics. Intravitreal amikacin was used based on microbiologic work-up. Results. The endophthalmitis part was controlled but the case developed amikacin induced macular infarction which jeopardized a good visual outcome. Conclusion. Nocardia endophthalmitis manifests late after cataract surgery in an aggressive manner and carries a poor visual prognosis. An early diagnosis and the use of correct antibiotic regimen may salvage the vision. But the present case shows that one should always be wary of potential retinal toxicity with intravitreal amikacin.http://dx.doi.org/10.1155/2016/2365945
spellingShingle Sikander A. K. Lodhi
G. Ashok Kumar Reddy
C. Aruna Sunder
Postoperative Nocardia Endophthalmitis and the Challenge of Managing with Intravitreal Amikacin
Case Reports in Ophthalmological Medicine
title Postoperative Nocardia Endophthalmitis and the Challenge of Managing with Intravitreal Amikacin
title_full Postoperative Nocardia Endophthalmitis and the Challenge of Managing with Intravitreal Amikacin
title_fullStr Postoperative Nocardia Endophthalmitis and the Challenge of Managing with Intravitreal Amikacin
title_full_unstemmed Postoperative Nocardia Endophthalmitis and the Challenge of Managing with Intravitreal Amikacin
title_short Postoperative Nocardia Endophthalmitis and the Challenge of Managing with Intravitreal Amikacin
title_sort postoperative nocardia endophthalmitis and the challenge of managing with intravitreal amikacin
url http://dx.doi.org/10.1155/2016/2365945
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AT gashokkumarreddy postoperativenocardiaendophthalmitisandthechallengeofmanagingwithintravitrealamikacin
AT carunasunder postoperativenocardiaendophthalmitisandthechallengeofmanagingwithintravitrealamikacin