NOCARDIA KERATITIS A CASE SERIES

Nocardia keratitis is an opportunistic and potentially aggressive infection and is believed to be a rare entity. Nocardia are aerobic, gram-positive, non-motile and branching filamentous bacteria. Trauma is the most common predisposing factor for Nocardia keratitis. The clinical picture usually consists of superficial patchy infiltrates, which may be arranged in a wreath pattern. Presence of gram-positive, branching, beaded filaments that stain with 1 acid-fast stain in smears of corneal scrapings is suggestive of Nocardial infection. Nocardia grow on commonly used media as tiny, white, dry colonies. Septran (trimethoprim-sulfamethoxazole) and Amikacin are effective drugs. Once therapy is initiated, the infiltrate responds promptly and resolves, forming a corneal scar. We describe five cases with culture-positive Nocardia keratitis who presented to our ophthalmology department.