Service d'ophtalmologie, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
BMC Infect Dis. 2011 Oct 31;11:296. doi: 10.1186/1471-2334-11-296.
The incidence rate of Nocardia keratitis is increasing, with new species identified thanks to molecular methods. We herein report a case of Nocardia transvalensis keratitis, illustrating this emerging pathology among travellers returning from Asia.
A 23-year-old man presented with a 10-week history of ocular pain, redness, and blurred vision in his right eye following a projectile foreign body impacting the cornea while motor biking in Thaïland. At presentation, a central epithelial defect with a central whitish stromal infiltrate associated with pinhead satellite infiltrates was observed. Identification with 16S rRNA PCR sequencing and microbiological culture of corneal scraping and revealed N. transvalensis as the causative organism. Treatment was initiated with intensive topical amikacin, oral ketoconazole and oral doxycycline. After a four-week treatment period, the corneal infiltrate decreased so that only a faint subepithelial opacity remained.
Nocardia organisms should be suspected as the causative agent of any case of keratitis in travelers returning from Asia. With appropriate therapy, Nocardia keratitis resolves, resulting in good visual outcome.
由于分子方法的应用，诺卡氏菌角膜炎的发病率正在增加，并且发现了新的菌种。我们在此报告一例由转越南诺卡氏菌引起的角膜炎病例，该病例说明了旅行者从亚洲返回后这种新出现的疾病。
一名 23 岁男性在泰国骑摩托车时，眼部被弹片击中角膜，10 周来出现眼部疼痛、发红和视力模糊。就诊时，观察到中央上皮缺损，伴有中央灰白色基质浸润，伴有针尖状卫星浸润。通过 16S rRNA PCR 测序和角膜刮片的微生物培养鉴定为转越南诺卡氏菌。治疗开始时采用局部阿米卡星、口服酮康唑和口服强力霉素。经过四周的治疗后，角膜浸润减少，仅残留轻微的上皮下混浊。
从亚洲返回的旅行者中任何角膜炎病例都应怀疑为诺卡氏菌引起的。经过适当的治疗，诺卡氏菌角膜炎可痊愈，视力预后良好。
