ENDOGENOUS NOCARDIA ENDOPHTHALMITIS PRESENTING AS A MASS LESION IN A PATIENT WITH METATSTATIC NONSMALL CELL CARCINOMA OF THE LUNG

Brian Lee, Paul Drayna, Amy Maltry, Craig M. Mason, Sandra Rocio Montezuma, Dara Koozekanani

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Abstract

PURPOSE: To report a case of Nocardia cyriacigeorgica endophthalmitis. METHODS: Case report. RESULTS: A 71-year-old man on long-term steroid therapy for poor respiratory function from lung carcinoma and presumed recent liver metastases presented with a four week history of blurry vision in the left eye. Ophthalmic examination revealed a white elevated mass in the macula with hemorrhage, concerning for metastasis. The patient was treated for presumed ocular metastases but had poor response to radiotherapy and was diagnosed four weeks later with N. cyriacigeorgica by retinal biopsy. Despite intravitreal and systemic antibiotics, the patient had progression of disease and died of respiratory involvement. CONCLUSION: Nocardia endogenous endophthalmitis can present as a mass retinal lesion in immunosuppressed patients with metastatic disease. Early vitreous and retinal biopsy may be required for definitive diagnosis and treatment. A pulmonary source of infection should be suspected and monitored closely.

Original languageEnglish (US)
Pages (from-to)145-149
Number of pages5
JournalRetinal cases & brief reports
Volume13
Issue number2
DOIs
StatePublished - Mar 1 2019

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Nocardia
Endophthalmitis
Neoplasm Metastasis
Carcinoma
Lung
Biopsy
Respiratory Therapy
Disease Progression
Radiotherapy
Steroids
Hemorrhage
Anti-Bacterial Agents
Liver
Infection
Therapeutics

PubMed: MeSH publication types

  • Case Reports
  • Journal Article

Cite this

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title = "ENDOGENOUS NOCARDIA ENDOPHTHALMITIS PRESENTING AS A MASS LESION IN A PATIENT WITH METATSTATIC NONSMALL CELL CARCINOMA OF THE LUNG",
abstract = "PURPOSE: To report a case of Nocardia cyriacigeorgica endophthalmitis. METHODS: Case report. RESULTS: A 71-year-old man on long-term steroid therapy for poor respiratory function from lung carcinoma and presumed recent liver metastases presented with a four week history of blurry vision in the left eye. Ophthalmic examination revealed a white elevated mass in the macula with hemorrhage, concerning for metastasis. The patient was treated for presumed ocular metastases but had poor response to radiotherapy and was diagnosed four weeks later with N. cyriacigeorgica by retinal biopsy. Despite intravitreal and systemic antibiotics, the patient had progression of disease and died of respiratory involvement. CONCLUSION: Nocardia endogenous endophthalmitis can present as a mass retinal lesion in immunosuppressed patients with metastatic disease. Early vitreous and retinal biopsy may be required for definitive diagnosis and treatment. A pulmonary source of infection should be suspected and monitored closely.",
author = "Brian Lee and Paul Drayna and Amy Maltry and Mason, {Craig M.} and Montezuma, {Sandra Rocio} and Dara Koozekanani",
year = "2019",
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T1 - ENDOGENOUS NOCARDIA ENDOPHTHALMITIS PRESENTING AS A MASS LESION IN A PATIENT WITH METATSTATIC NONSMALL CELL CARCINOMA OF THE LUNG

AU - Lee, Brian

AU - Drayna, Paul

AU - Maltry, Amy

AU - Mason, Craig M.

AU - Montezuma, Sandra Rocio

AU - Koozekanani, Dara

PY - 2019/3/1

Y1 - 2019/3/1

N2 - PURPOSE: To report a case of Nocardia cyriacigeorgica endophthalmitis. METHODS: Case report. RESULTS: A 71-year-old man on long-term steroid therapy for poor respiratory function from lung carcinoma and presumed recent liver metastases presented with a four week history of blurry vision in the left eye. Ophthalmic examination revealed a white elevated mass in the macula with hemorrhage, concerning for metastasis. The patient was treated for presumed ocular metastases but had poor response to radiotherapy and was diagnosed four weeks later with N. cyriacigeorgica by retinal biopsy. Despite intravitreal and systemic antibiotics, the patient had progression of disease and died of respiratory involvement. CONCLUSION: Nocardia endogenous endophthalmitis can present as a mass retinal lesion in immunosuppressed patients with metastatic disease. Early vitreous and retinal biopsy may be required for definitive diagnosis and treatment. A pulmonary source of infection should be suspected and monitored closely.

AB - PURPOSE: To report a case of Nocardia cyriacigeorgica endophthalmitis. METHODS: Case report. RESULTS: A 71-year-old man on long-term steroid therapy for poor respiratory function from lung carcinoma and presumed recent liver metastases presented with a four week history of blurry vision in the left eye. Ophthalmic examination revealed a white elevated mass in the macula with hemorrhage, concerning for metastasis. The patient was treated for presumed ocular metastases but had poor response to radiotherapy and was diagnosed four weeks later with N. cyriacigeorgica by retinal biopsy. Despite intravitreal and systemic antibiotics, the patient had progression of disease and died of respiratory involvement. CONCLUSION: Nocardia endogenous endophthalmitis can present as a mass retinal lesion in immunosuppressed patients with metastatic disease. Early vitreous and retinal biopsy may be required for definitive diagnosis and treatment. A pulmonary source of infection should be suspected and monitored closely.

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