Table 1 Clinical Characteristics of Nocardia Keratitis Cases (2014–2021)
From: Nocardia keratitis: amikacin nonsusceptibility, risk factors, and treatment outcomes
Case | Age/Sex | Risk Factors | Days to Presentation | Presenting Visual Acuity | Presentation | Days to Resolution | Last Follow-up Visual Acuity | Species | Topical Steroid Use |
|---|---|---|---|---|---|---|---|---|---|
1 | 49/F | Contact lens wear | 5 | 20/20 | 1.4 mm corneal epithelial defect w/ underlying infiltrate | 19 | 20/20 | Nocardia beijingensis/ pneumoniae/araoensis | No |
2 | 24/F | Contact lens wear; trauma | 14 | 20/25 | Inferior patchy infiltrate 5 mm × 2.5 mm with patchy overlying corneal epithelial defects | 56 | 20/20 | Nocardia amikacinitolerans | No |
3 | 64/M | Contact lens wear (BCL) | 14 | No Light Perception | Central 1.6 mm × 1.6 mm white chalky infiltrate | Lost to Follow Up | No Light Perception | Nocardia testacea | Yes |
4 | 20/F | Contact lens wear | 19 | 20/70 | 2.2 mm × 2.2 mm inferonasal round patch of irregular multifocal white infiltrates, minimal corneal thinning, irregular overlying punctate corneal staining, no dendrites | 54 | 20/25 | Nocardia beijingensis | No |
5 | 25/M | Contact lens wear | 10 | 20/40–2 | 1 mm × 1.4 mm white fluffy opacity with irregular borders; satellite sub 1 mm round lesion, no staining, no neovascularization | 44 | 20/70 | Nocardia amikacinitolerans | No |
6 | 21/M | Contact lens wear | 14 | 20/30 | Irregular epithelium with pseudodendritic appearance 5 mm non-continuously, scattered anterior stromal infiltrate with pannus | 39 | 20/40–1 | Nocardia amikacinitolerans | Yes |
7 | 66/M | Trauma | 7 | 0.5/200 | 2 mm × 2 mm corneal ulcer with corneal epithelial defect and Descemet’s folds | 20 | 0.5/200 | Nocardia harenae | Yes |
8 | 55/M | Contact lens wear (soft); trauma | 10 | 20/25 | Inferior soupy 1.5 mm circular ulcer | Lost to Follow Up | Lost to Follow Up | Nocardia amikacinitolerans | No |
9 | 56/F | Contact lens wear | 5 | 20/70 | 7 discrete, round corneal epithelial defects with anterior stromal infiltrate underlying | 6 | 20/40 | Nocardia amikacinitolerans | No |
10 | 19/M | Trauma | 3 | 20/20 | ~ 0.9 mm × 0.9 mm patchy infiltrate, edges are more opaque and not contiguous, focal mild Descemet’s folds, surrounding infiltrate looks dense | 49 | 20/20 | Nocardia farcinica | No |
11 | 24/M | Contact lens wear | 70 | 20/30 | 2+ infiltrate, 4.5 mm × 2 mm ring infiltrate, no hypopyon | 45 | 20/30 | Nocardia beijingensis/ pneumoniae | No |
12 | 38/M | Contact lens wear (soft) | 13 | 20/400 | Corneal epithelial defect 2 mm × 3 mm, questionable infiltrate on borders, no satellite (suspected HSV keratitis), corneal epithelial defect with neovascular limbal vessels. Central haze and infiltrate, mild punctate stain | 190 | 20/30 | Nocardia arthritidis | Yes |
13 | 16/M | Contact lens wear | 14 | 20/30 | 2.5 mm clusters of superficial infiltrates without thinning | 43 | 20/25 | Nocardia amikacinitolerans | Yes |
14 | 52/M | Contact lens wear | 30 | 20/20 | Ring infiltrate with central haze | 64 | 20/20 | Nocardia veterana | Yes |
15 | 30/M | Contact lens wear | 10 | 20/25 | Large lesion with raised edges and scattered staining | 47 | 20/20 | Nocardia amikacinitolerans | No |
16 | 21/M | Contact lens wear | 17 | 20/30 | 4.6 mm × 4.4 mm area of stromal infiltrate with discrete white opacities, white ring at the border 360 that stains, otherwise no staining. Some enlarged corneal nerves. No endothelial plaque | 137 | 20/25 | Nocardia amikacinitolerans | Yes |
17 | 17/M | Contact lens wear (soft) | 5 | 20/30 | 1 mm ×1 mm ulcer with small infiltrate at margin of lesion and overlying epithelial defect | 9 | 20/20 | Nocardia amikacinitolerans | No |
18 | 52/F | Contact lens wear | 4 | 20/20 | Inferotemporal, inferior and superior pinpoint infiltrates, very pinpoint corneal epithelial defect | 50 | 20/20 | Nocardia arthritidis | Yes |
19 | 36/F | Contact lens wear | 10 | 20/25 + 1 | Central corneal ulcer, 1.5 mm × 1.6 mm, with 25% thinning, underlying Descemet’s folds, diffuse epithelial edema, peripheral staining of ulcer edges | Lost to Follow Up | 20/25–2 | Nocardia amikacinitolerans/ beijingensis | Yes |
20 | 35/M | Contact lens wear | 9 | 20/400 | Pannus, multiple small infiltrates 0.2 mm × 0.2 mm with overlaying corneal epithelial defect arranged roughly in a circle (nonconfluent), no dendrites | 134 | 20/100 | Nocardia asteroides complex | No |
21 | 27/M | Contact lens wear | 14 | 20/100 | 1 mm × 1 mm with infiltrate | 7 | 20/80 | Nocardia endophytica | Yes |
22 | 16/M | Contact lens wear | Not Available | 20/300 | 2.3 mm × 2.4 mm superficial corneal lesion, with pseudo dendrites emanating from the center of the lesion | 49 | 20/20 | Nocardia beijingensis | Yes |
23 | 23/F | Contact lens wear | 7 | 20/25 | 2.9 mm × 2.1 mm infiltrate concentrated on periphery of lesion. Scattered small corneal epithelial defects around periphery of lesion. Minimal cornea edema surrounding. | 25 | 20/40 | Nocardia amikacinitolerans | No |
24 | 56/M | Trauma | 7 | 20/40 | Dendriform corneal epithelial defect with underlying opacity outside visual axis < 1 mm in size | 16 | 20/50 | Nocardia amikacinitolerans | No |
25 | 38/F | Contact lens wear | 7 | 20/30–2 | 1.8 mm epithelial defect with anterior stromal infiltrate at edges and surrounding haze. No thinning | 3 | 20/40 | Nocardia bhagyanarayanae | No |
26 | 54/M | Contact lens wear | 7 | 20/70 | Not available | 51 | 20/40 | Nocardia beijingensis | Yes |