• Medicine · Nov 2022

    Case Reports

    Successful control of scleritis caused by Nocardia farcinica: A case report.

    • Zhongkai Hao, Hui Dang, Xin Gao, Chenming Zhang, Aijun Deng, Yue Tan, and Gang Ding.
    • Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang, China.
    • Medicine (Baltimore). 2022 Nov 11; 101 (45): e31481e31481.

    RationaleNocardia farcinica is an opportunistic pathogen that rarely causes ocular infections. This study reviewed a case of N. farcinica-mediated scleritis involving the corneal limbus.Patient ConcernsA 56-year-old man was admitted to the Department of Keratology of Jinan Second People's Hospital due to "a red and swollen right eye accompanied with severe pain for >1 month." He denied any history of hypertension, diabetes, systemic immune diseases and eye surgery.DiagnosesCorneal defect and scleral necrosis were observed by slit lamp. Combination of anterior segment optical coherence tomography and ophthalmic ultrasound biomicroscopy was used for diagnosis and evaluation of corneal and scleral conditions. Culture and metagenomic sequencing verified that the pathogen of scleritis was N. farcinica.InterventionsThe patient was treated by sulfacetamide sodium eye drops, oral administration of sulfamethoxazole tablets, amikacin anterior chamber flushing, scleral debridement, and allogeneic scleral transplantation.OutcomesThe disease was successfully controlled.LessonsInfectious scleritis caused by N. farcinica is extremely rare. Culture of pathogenic microorganisms remains to be the gold standard for the diagnosis of infectious eye diseases. Metagenomic sequencing shows potential promise in the diagnosis of infectious eye diseases. N. farcinica is sensitive to sulfonamides and amikacin.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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