• Ayse Bahar Kelesoglu Dincer, Serdar Sezer, Mucteba Enes Yayla, and Gulay Kinikli.
• Department of Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey.
• J Coll Physicians Surg Pak. 2022 Dec 1; 32 (12): SS149SS150SS149-SS150.

AbstractA 62-year male patient, diagnosed with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), developed proptosis and decrease in visual acuity while on rituximab treatment. As the ophthalmological examination and imaging studies could not exclude tumour of the orbit, enucleation of the orbit was performed. The histopathology displayed necrosis and inflammation. Because the clinical, laboratory and pathological findings of the patient suggested a vasculitis exacerbation, the immunosuppressive treatment was continued. However, the patient developed confusion and hemiplegia with cerebral mass lesions on imaging. The subsequent report of the pathology revealed a nocardial infection of the eye. The patient was diagnosed with nocardiosis with ocular and cerebral involvement. Despite efficient antimicrobial therapy, the disease progressed rapidly causing death. This case is unique as it describes disseminated nocardiosis with ocular and cerebral involvement in an AVV patient. Key Words: Immunosuppression, Nocardiosis, ANCA-associated vasculitis, Proptosis.

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