PDF(Pubmed)
Abstract：
Nocardia endophthalmitis is a relatively uncommon form of endophthalmitis seen in clinical patients. In general, Nocardia endophthalmitis tends to carry a poor prognosis. Here, we report a 3-year-old child who was admitted to the hospital due to a rupture of the left eye. The suturing and anterior chamber formation were performed immediately. Approximately, 16 days after the operation, massive whitish plump and tufted exudates gathered in the pupil area and at the bottom of the anterior chamber, and the child was diagnosed with endophthalmitis. The infection was initially considered to be caused by fungal pathogens for that the hyphae and spores were observed in the smear. However, the isolate obtained after 4 days of culturation was identified as actinomycetes using MALDI-TOF. We further classified it as Nocardia huaxiensis by next-generation sequencing (NGS) based on the MinION platform. Amikacin and sulfamethoxazole tablets were used to control the infection and the ocular inflammation subsided gradually. Intraocular lens (IOL) implantation is planned to be performed at an appropriate future time to improve his vision. Nocardia endophthalmitis is rare and usually caused by ocular trauma or surgery. In conclusion, Nocardia huaxiensis should be considered as an emerging pathogen and deserves more attention.
摘要：
诺卡氏菌眼内炎是临床患者中相对罕见的眼内炎形式。总的来说,诺卡氏菌眼内炎往往预后不良。这里,我们报告一名3岁儿童因左眼破裂入院.立即进行缝合和前房形成。大约,手术后16天，大量白色丰满和簇状的分泌物聚集在瞳孔区域和前房底部，孩子被诊断患有眼内炎。最初认为感染是由真菌病原体引起的,因为在涂片中观察到菌丝和孢子。然而,培养4天后获得的分离株使用MALDI-TOF鉴定为放线菌。我们通过基于MinION平台的下一代测序（NGS）将其进一步分类为华氏诺卡氏菌。应用阿米卡星和磺胺甲恶唑片控制感染，眼部炎症逐渐消退。计划在未来适当的时间进行人工晶状体（IOL）植入，以改善视力。诺卡氏菌眼内炎很少见，通常由眼外伤或手术引起。总之,华氏诺卡氏菌应被认为是一种新兴的病原体，值得关注。
