A case of atypical nocardia asteroides sclerouveitis resistant to fourth-generation fluoroquinolones

Abstract

ABSTRACT We describe an unusual case of Nocardia spp scleritis in a health girl resistant to topical fourth-generation fluoroquinolones. Clinically, there was only partial response of the scleritis to initial therapy. Treatment was changed to meropenem intravenously and topical amikacin. Following several weeks of antibiotic treatment, the patient's infection resolved but her vision was reduced to no light perception. Nocardia asteroides must be considered as a possible agent in cases of necrotizing scleritis in patients without a clear source. Antibiotic sensitivity testing has a definitive role in view of the resistance to these new medications.

Keywords

• Scleritis/microbiology
• Scleritis/pathology
• Scleritis/therapy
• Nocardia asteroides/isolation & purification
• Fluoquinolones
• Eye infections/microbiology
• Drug resistance
• Case reports