Nocardia endophthalmitis following uncomplicated phacoemulsification and implantation of a posterior chamber intraocular lens.

A patient developed endophthalmitis 15 days after uncomplicated cataract extraction. Excised infectious material sequestered in the capsular bag revealed Nocardia on culture. She required multiple intravitreal injections of Amikacin and dexamethasone, pars plana vitrectomies with explantation of the lens, and chronic topical and oral sulfonamide antibiotics to control the infection. Clinicians should also consider Nocardia when the suspicion of fungal endophthalmitis is entertained, as Nocardia are resistant to antifungals, but respond to intravitreal amikacin and chronic topical and oral sulfonamides.