Chronic Nocardia asteroides endophthalmitis after extracapsular cataract extraction
P. L. Zimmerman, N. Mamalis, J. B. Alder, M. P. Teske, M. Tamura and G. R. Jones
Department of Ophthalmology, University of Utah, Salt Lake City.
A 65-year-old man underwent an uncomplicated extracapsular cataract
extraction with placement of a posterior chamber intraocular lens. The
patient developed delayed-onset chronic endophthalmitis caused by Nocardia
asteroides. This was confirmed on multiple intraocular cultures, as well as
histopathologic examination of the lens capsular bag. The patient was
treated with periocular, intravitreal, and systemic antibiotic treatment,
combined with intraocular lens removal, total capsulectomy, and three
vitrectomies in an attempt to eradicate the organism and calm the eye. The
patient went on to develop widespread endophthalmitis that required
enucleation of the infected globe. To our knowledge, this is the first case
of delayed-onset chronic endophthalmitis caused by N asteroides after
extracapsular cataract extraction with a posterior chamber intraocular
lens.
