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Nocardia infection following ocular surface surgery

OBJECTIVE: To investigate the clinical characteristics and treatment outcomes of Nocardia infection after ocular surface surgery. METHODS: This is a retrospective study. Eight cases of culture-proven Nocardia infection, which developed within 1 month after ocular surface surgery were included. Demog...

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Autores principales: Wang, Jingting, Lu, Xiuhai, Wang, Jungang, Wang, Shuting, Shi, Weiyun, Li, Suxia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042929/
https://www.ncbi.nlm.nih.gov/pubmed/36104589
http://dx.doi.org/10.1007/s10792-022-02500-5
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author Wang, Jingting
Lu, Xiuhai
Wang, Jungang
Wang, Shuting
Shi, Weiyun
Li, Suxia
author_facet Wang, Jingting
Lu, Xiuhai
Wang, Jungang
Wang, Shuting
Shi, Weiyun
Li, Suxia
author_sort Wang, Jingting
collection PubMed
description OBJECTIVE: To investigate the clinical characteristics and treatment outcomes of Nocardia infection after ocular surface surgery. METHODS: This is a retrospective study. Eight cases of culture-proven Nocardia infection, which developed within 1 month after ocular surface surgery were included. Demographics and clinical history of patients were investigated. RESULTS: There were 8 eyes (2 left and 6 right) of 8 patients (5 males and 3 females), aged 27–65, with a median age of 52.9 years. Three cases underwent pterygium excision, three were subjected to conjunctival flap covering, and two were treated with lamellar corneal transplantation. The time interval between previous surgery and the onset of symptoms varied from 7 to 28 days (mean = 20.5 ± 7.13 days). All the cases presented grey-white infiltrates at the surgical incision site while appearing with six corneal ulcers and two conjunctival ulcers. Filaments of Nocardia were founded by confocal microscopy in two of the five cases. All responded poorly to medical therapy. Seven of the eight cases were treated with reoperation. Nocardia infection recurred in three cases after reoperation, and one was eviscerated. CONCLUSIONS: Surgical trauma is a risk factor for ocular Nocardia infection. Nocardia infection should be suspected when secondary infection occurs in a surgical incision with an atypical clinical presentation. The use of corticosteroids may influence the efficacy of drugs. Complete removal of lesions may lower the recurrence of Nocardia infection with poor drug treatment effects.
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spelling pubmed-100429292023-03-29 Nocardia infection following ocular surface surgery Wang, Jingting Lu, Xiuhai Wang, Jungang Wang, Shuting Shi, Weiyun Li, Suxia Int Ophthalmol Original Paper OBJECTIVE: To investigate the clinical characteristics and treatment outcomes of Nocardia infection after ocular surface surgery. METHODS: This is a retrospective study. Eight cases of culture-proven Nocardia infection, which developed within 1 month after ocular surface surgery were included. Demographics and clinical history of patients were investigated. RESULTS: There were 8 eyes (2 left and 6 right) of 8 patients (5 males and 3 females), aged 27–65, with a median age of 52.9 years. Three cases underwent pterygium excision, three were subjected to conjunctival flap covering, and two were treated with lamellar corneal transplantation. The time interval between previous surgery and the onset of symptoms varied from 7 to 28 days (mean = 20.5 ± 7.13 days). All the cases presented grey-white infiltrates at the surgical incision site while appearing with six corneal ulcers and two conjunctival ulcers. Filaments of Nocardia were founded by confocal microscopy in two of the five cases. All responded poorly to medical therapy. Seven of the eight cases were treated with reoperation. Nocardia infection recurred in three cases after reoperation, and one was eviscerated. CONCLUSIONS: Surgical trauma is a risk factor for ocular Nocardia infection. Nocardia infection should be suspected when secondary infection occurs in a surgical incision with an atypical clinical presentation. The use of corticosteroids may influence the efficacy of drugs. Complete removal of lesions may lower the recurrence of Nocardia infection with poor drug treatment effects. Springer Netherlands 2022-09-14 2023 /pmc/articles/PMC10042929/ /pubmed/36104589 http://dx.doi.org/10.1007/s10792-022-02500-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Paper
Wang, Jingting
Lu, Xiuhai
Wang, Jungang
Wang, Shuting
Shi, Weiyun
Li, Suxia
Nocardia infection following ocular surface surgery
title Nocardia infection following ocular surface surgery
title_full Nocardia infection following ocular surface surgery
title_fullStr Nocardia infection following ocular surface surgery
title_full_unstemmed Nocardia infection following ocular surface surgery
title_short Nocardia infection following ocular surface surgery
title_sort nocardia infection following ocular surface surgery
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042929/
https://www.ncbi.nlm.nih.gov/pubmed/36104589
http://dx.doi.org/10.1007/s10792-022-02500-5
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