Nocardia choroidal abscess in a patient with systemic lupus erythematosus.
OBJECTIVE
Nocardia asteroides, a respiratory saprophyte in humans, may cause localized infection of the lungs in debilitated or immunosuppressed individuals. Haematogenous spread to the eye via the choroidal circulation may result in choroidal abscess formation.


METHODS
We report the development of a choroidal abscess in the left eye of a woman treated with steroids and cyclophosphamide for systemic lupus erythematosus. Haematogenous spread of N. asteroides from a localized infection of the lung (empyema) is thought to have been the cause of the choroidal abscess.


RESULTS
Surgical drainage of the empyema combined with intravenously administered antibiotics resulted in resolution of the choroidal abscess and improvement of vision.


CONCLUSIONS
A choroidal abscess, caused by haematogenous spread of N. asteroides, may respond to appropriate systemic antibiotic treatment alone and not require ocular treatment.
Yap
E Y
EY
Department of Ophthalmology, Tan Tock Seng Hospital, Singapore. EngYiatYap/Medical/TTSH@TTSH
Fam
H B
HB
Leong
K P
KP
Buettner
H
H
D000038:Abscess / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D015862:Choroid Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D016724:Empyema, Pleural / Q000382:microbiology / Q000601:surgery / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D009617:Nocardia Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D009616:Nocardia asteroides / Q000302:isolation & purification; D013396:Suction; D014463:Ultrasonography
D000900:Anti-Bacterial Agents