title: ENDOGENOUS NOCARDIA ENDOPHTHALMITIS PRESENTING AS A MASS LESION IN A PATIENT WITH METATSTATIC NONSMALL CELL CARCINOMA OF THE LUNG.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota.|Hennepin County Medical Center, Minneapolis, Minnesota.
authors.forename: Brian
authors.initials: B
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Paul
authors.initials: P
authors.lastname: Drayna
authors.affiliation: Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Maltry
authors.affiliation: Retina Consultants, LTD, Fargo, North Dakota.
authors.forename: Craig M
authors.initials: CM
authors.lastname: Mason
authors.affiliation: Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Montezuma
authors.affiliation: Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Dara
authors.initials: D
authors.lastname: Koozekanani
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications*; D003937:Diagnosis, Differential; D009877:Endophthalmitis / Q000382:microbiology*; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D009615:Nocardia / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000382:microbiology*