title: Endogenous Nocardial Endophthalmitis in an Immunosuppressed Patient: A Serious Warning of an Underlying Life Threatening and Blinding Disorder.
abstract: OBJECTIVE
  To report a case of bilateral endogenous nocardial endophthalmitis with central nervous system involvement in an immunocompromised individual with an extremely poor outcome.
  
  
  METHODS
  A 35-year-old man with a history of long-term, prescribed oral steroid use for membranoproliferative glomerulonephritis presented with profound bilateral vision loss. Patient's diagnosis of bilateral endogenous nocardial endophthalmitis was delayed. Nocardia was finally isolated from a brain biopsy after a repeat magnetic resonance imaging revealed a brain abscess. With anti-nocardia therapy, patient improved systemically, but the visual outcome was poor, with no light perception in both eyes.
  
  
  CONCLUSIONS
  Ocular nocardiosis is a serious vision and life threatening disorder, particularly in patients on immunosuppressive therapy. A high index of suspicion is required for successful treatment.
authors.affiliation: Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India.
authors.forename: Hemant
authors.initials: H
authors.lastname: Trehan
authors.affiliation: Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India; Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Jaya
authors.initials: J
authors.lastname: Kaushik
authors.affiliation: Department of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.
authors.forename: Vaibhav Kumar
authors.initials: VK
authors.lastname: Jain
authors.affiliation: Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India.
authors.forename: Jitendra Kumar Singh
authors.initials: JK
authors.lastname: Parihar
authors.affiliation: Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Avasthi
keywords: Ahmed Glaucoma Valve; Bilateral Endogenous Nocardial Endophthalmitis; Brain Abscess; Glomerulonephritis; Membranoproliferative Glomerulonephritis; Ocular Nocardiosis