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

• Main Authors: Túlio Frade Reis, Marina Labarrère de Albuquerque, Vânia Martins Ribeiro Hummel, João Eudes Filho, Patrick Frensel Tzelikis
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Oftalmologia
• Series: Revista Brasileira de Oftalmologia
• Subjects: Scleritis/microbiology; Scleritis/pathology; Scleritis/therapy; Nocardia asteroides/isolation & purification; Fluoquinolones; Eye infections/microbiology; Drug resistance; Case reports
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802016000400322&lng=en&tlng=en
• ISSN: 1982-8551

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.