Nocardia Keratitis : A case report

Abstract

Infective keratitis can on occasion end up in diagnostic difficulty. This is more so if the patient is on immunosuppressants as it can alter the clinical presentation. We report a case of a 39 year old patient who underwent renal transplantation in 2007, and is currently on immunosuppressants. She presented with a painful red eye and had features of marginal keratitis. There was a poor response to empirical antibiotic therapy. Due to the prolonged disease process and infiltration of the cornea, she had an imminent perforation. Surgical intervention and appropriate antibiotic therapy following identification of the causative organism as Nocardia spp. resulted in full recovery. Although there are a few case reports of Nocardia keratitis in immuno-compromised patients in the international literature, this appears to be the first documented case reported in Sri Lanka.