Subretinal abscess due to Nocardia farcinica resistant to trimethoprim- sulfamethoxazole in a patient with systemic lupus erythematosus.
OBJECTIVE
To report a case of subretinal abscess due to Nocardia farcinica resistant to trimethoprim-sulfamethoxazole in a patient with systemic lupus erythematosus on immunosuppressive therapy.


METHODS
Observational case report.


METHODS
We retrospectively studied the medical record of a patient with nocardiosis.


RESULTS
The microorganism disseminated from the lungs (pneumonia) to the eye and brain. The ocular lesion appeared to be a yellowish, lobulated subretinal abscess with irregular surface and superficial retinal hemorrhages. As it was not responding to empiric therapy for nocardia, pars plana vitrectomy and aspiration of the subretinal material was performed to confirm the etiology.


CONCLUSIONS
In an immunocompromised patient with pulmonary involvement and a subretinal abscess with a characteristic aspect, one should consider nocardia as a possible etiology taking into account its possible antibiotic resistances.
Dodds
Emilio M
EM
Hospital Juan A. Fernández, Buenos Aires, Argentina. emdodds@consultoresoftalmologicos.com
Echandi
Laura V
LV
Puente
Susana I
SI
Kaufman
Sara
S
D000038:Abscess / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D009615:Nocardia / Q000187:drug effects / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D012164:Retinal Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D012189:Retrospective Studies; D014296:Trimethoprim Resistance; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology*; D014821:Vitrectomy
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination