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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Subretinal abscess due to nocardia in an immunosuppressed patient: a case report
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Vol. 98. Issue 11.
Pages 656-659 (November 2023)
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Vol. 98. Issue 11.
Pages 656-659 (November 2023)
Short communication
Subretinal abscess due to nocardia in an immunosuppressed patient: a case report
Absceso subretiniano por Nocardia en paciente inmunodeprimido: a propósito de un caso
A. Ibeas Martínez
Corresponding author
, J.M. Ibáñez Aguirre, J.J. Araiz Iribarren, M.Y. Jadraque Ruiz, N.M. Rolón Ruiz, I. Goenaga Fernández
Servicio de Oftalmología, Hospital San Eloy, Barakaldo, Vizcaya, Spain
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Abstract

Systemic nocardiosis is a rarely occurring pathology, but its hematogenous spread across the eye is even less likely to occur, with only a few recorded cases. Therefore, it is not usually taken into account when a subretinal abscess is being considered for a diagnosis. However, when confronting a case with a history of immunosupression and pulmonary disease, the examination of the ocular fundus may be a very successful approach. With such aim we introduce the case of a 45-year-old immunosupressed male, without a history of pulmonary disease, whose subretinal mass evolution is accordant with an abscess. In the end, being etiologically diagnosed by means of a vitrectomy, it was concluded that the abscess was due to an infection of nocardia cyriacigeorgica, an emergent pathogen. Thus the aforementioned case is to be considered in the present study, along others, in order to shed more light on a disease which may not be readily diagnosed on account of its infrequency.

Keywords:
Nocardia cyriacigeorgica
Subretinal abscess
Immunosuppression
Biopsy
Resumen

La nocardiosis sistémica es una patología poco frecuente. Su diseminación por vía hematógena al globo ocular lo es aún todavía más, con muy pocos casos documentados, por lo que su sospecha como posible diagnóstico en caso de absceso subretiniano no es la norma. Sin embargo, con unos antecedentes de inmunodepresión y patología pulmonar, la imagen de fondo de ojo es enormemente sugestiva. Presentamos el caso de un varón de 45 años imnumosuprimido, sin clínica pulmonar, que debuta con una masa subretiniana que por su evolución es compatible con un absceso, diagnosticado etiológicamente en última instancia mediante vitrectomía como infección por Nocardia cyriacigeorgica, un patógeno emergente. Sumamos así nuestro caso, con sus peculiaridades, a otros para documentar una enfermedad que por su infrecuencia puede ser tardíamente diagnosticada.

Palabras clave:
Nocardia cyriacigeorgica
Absceso subretiniano
Inmunosupresión
Biopsia

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