Endogeneous Nocardia Subretinal Abscess

Nocardia is a gram-positive, weakly acid-fast, filamentous, soil-borne aerobic bacterium that has some morphological and staining features in common with fungi.1,2 Endogenous intraocular nocardiosis is a rarely reported entity.1,2 To our knowledge, the electron microscopic features of intraocular Nocardia have not been reported previously.Report of a Case. A 40-year-old black woman with severe renal disease was treated with a cadaveric renal transplant and immunosuppressive medications. Five months later she presented with fever, lethargy, and reduced vision. Funduscopic examination of the right eye disclosed a 4+ vitritis and a 6-mm-diameter well-circumscribed subretinal mass superonasally with an adjacent exudative retinal detachment. A chest radiograph revealed a right upper lobe cavitary lesion. Cranial computed tomography disclosed an occipital infarct, hydrocephalus, and multiple brain abscesses. Meningitis was diagnosed by lumber puncture. A biopsy specimen was taken of the cavitary lung lesion, which showed organisms consistent with Nocardia. She was treated with