Phillips W B, Shields C L, Shields J A, Eagle R C, Masciulli L, Yarian D L
Wills Eye Hospital, Philadelphia, PA 19107.
Br J Ophthalmol. 1992 Nov;76(11):694-6. doi: 10.1136/bjo.76.11.694.
Nocardia is a Gram positive, aerobic, filamentous branching micro-organism that rarely causes human infection. When infection does occur it usually takes the form of a subcutaneous abscess or a pneumonia-like illness. We describe a case of a patient with chronic lymphocytic leukaemia who developed painless loss of vision in the right eye secondary to a choroidal abscess after a prolonged course of treatment on several immunosuppressive agents. The patient also complained of right shoulder pain that was unresponsive to conventional therapy, and had been admitted and treated for several episodes of 'pneumonia'. A diagnostic transvitreal fine-needle aspiration biopsy of the ocular lesion was performed which demonstrated Nocardia asteroides. This allowed for appropriate antibiotic therapy to be instituted early in the course of the infection and prompted the systemic work-up which also demonstrated central nervous system and arthropic nocardial infection.
诺卡菌是一种革兰氏阳性、需氧、丝状分支的微生物，很少引起人类感染。当感染确实发生时，通常表现为皮下脓肿或类似肺炎的疾病。我们描述了一例慢性淋巴细胞白血病患者，在接受多种免疫抑制剂的长期治疗后，继发脉络膜脓肿，导致右眼无痛性视力丧失。患者还抱怨右肩疼痛，对传统治疗无反应，并且因多次“肺炎”发作入院治疗。对眼部病变进行了诊断性经玻璃体细针穿刺活检，结果显示为星形诺卡菌。这使得在感染过程早期就能够开始适当的抗生素治疗，并促使进行全身检查，结果也显示存在中枢神经系统和关节诺卡菌感染。
