Nocardial scleritis: A case report and a suggested algorithm for disease management based on a literature review

Laura Pires da Cunha; Verena Juncal; Cecília Godoy Carvalhaes; Sylvia Cardoso Leão; Erica Chimara; Denise Freitas

doi:10.1016/j.ajoc.2018.01.018

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Nocardial scleritis: A case report and a suggested algorithm for disease management based on a literature review

Journal article

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Nocardial scleritis: A case report and a suggested algorithm for disease management based on a literature review

Laura Pires da Cunha, Verena Juncal, Cecília Godoy Carvalhaes, Sylvia Cardoso Leão, Erica Chimara and Denise Freitas

American journal of ophthalmology case reports, Vol.10, pp.1-5

06/2018

DOI: 10.1016/j.ajoc.2018.01.018

PMCID: PMC5956651

PMID: 29780901

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Abstract

To report a case of nocardial scleritis and to propose a logical treatment algorithm based on a literature review. It is important to suspect a nocardial infection when evaluating anterior unilateral scleritis accompanied by multiple purulent or necrotic abscesses, especially in male patients with a history of chronic ocular pain and redness, trauma inflicted by organic materials, or recent ophthalmic surgery. A microbiological investigation is essential. In positive cases, a direct smear reveals weakly acid-fast organisms or Gram-positive, thin, beading and branching filaments. Also, the organism (usually) grows on blood agar and Lowenstein-Jensen plates. An infection can generally be fully resolved by debridement of necrotic areas and application of topical amikacin drops accompanied by systemic sulfamethoxazole-trimethoprim. Together with the case report described, we review data on a total of 43 eyes with nocardial scleritis. Our proposed algorithm may afford a useful understanding of this sight-threatening disease, facilitating easier and faster diagnosis and management.

Microbiology

Infection

Nocardia

Scleral disease

Necrotizing

Details

Title: Subtitle: Nocardial scleritis: A case report and a suggested algorithm for disease management based on a literature review
Creators: Laura Pires da Cunha - Hospital São Paulo
Verena Juncal - Universidade Federal de São Paulo
Cecília Godoy Carvalhaes - Universidade Federal de São Paulo
Sylvia Cardoso Leão - Universidade Federal de São Paulo
Erica Chimara - Instituto Adolfo Lutz
Denise Freitas - Hospital São Paulo
Resource Type: Journal article
Publication Details: American journal of ophthalmology case reports, Vol.10, pp.1-5
DOI: 10.1016/j.ajoc.2018.01.018
PMID: 29780901
PMCID: PMC5956651
NLM abbreviation: Am J Ophthalmol Case Rep
ISSN: 2451-9936
eISSN: 2451-9936
Language: English
Date published: 06/2018
Academic Unit: Pathology
Record Identifier: 9984185278802771

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