title: Nocardia keratitis after laser in situ keratomileusis: clinicopathologic correlation.
abstract: A case of Nocardia asteroides keratitis occurring 3 weeks after laser in situ keratomileusis (LASIK) in a nontraumatized eye is reported. The patient presented with decreased vision, inflammation, and stromal melting of the LASIK flap, discrete infiltrates, and an anterior chamber cellular reaction. Cultures for acid-fast bacteria grew Nocardia asteroides after 5 days. Infection progressed despite treatment with topical antibiotics and eventually required penetrating keratoplasty (PKP). Postoperatively, the patient was placed on moxifloxacin, a fourth-generation flouroquinolone. The patient experienced a recurrence of Nocardia keratitis at the graft-host interface 2 months after the PKP. This eventually resolved with a combination of topical moxifloxacin and imipenem therapy.
authors.affiliation: Departments of Ophthalmology, Ross Eye Institute, Buffalo, New York, USA.
authors.forename: Nisha R
authors.initials: NR
authors.lastname: Patel
authors.forename: James J
authors.initials: JJ
authors.lastname: Reidy
authors.forename: Federico
authors.initials: F
authors.lastname: Gonzalez-Fernandez
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007634:Keratitis / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D015948:Keratoplasty, Penetrating; D008875:Middle Aged; D000077266:Moxifloxacin; D009336:Necrosis; D009617:Nocardia Infections / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D009616:Nocardia asteroides; D011804:Quinolines / Q000627:therapeutic use; D012008:Recurrence
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D015378:Imipenem; D000077266:Moxifloxacin