Case of Nocardia Cyriacigeorgica Infection of the Eye in a Granulomatosis With Polyangiitis Patient

Abstract

Nocardiosis is an infectious disease caused by a group of organisms that are often found in soil and has a very rare incidence of infecting immunocompromised patients. Granulomatosis with polyangiitis patients are often susceptible to being infected with many atypical organisms such as Nocardia cyriacigeorgica. We present a case of a 35-year-old male who is a known case of granulomatosis with polyangiitis and has a repeated history of farm visits. The patient presented with progressive early morning right eye secretions followed by dryness throughout the day with no history of trauma or allergy of seven months duration. An eye swab for culture and sensitivity showed an isolated Nocardia cyriacigeorgica and was treated by trimethoprim/sulfamethoxazole (Bactrim) for one year but was lost to follow-up. Early detection of Nocardia cyriacigeorgica is crucial in those groups of patients, as it can prevent further complicated outcomes while proper hygiene education is important.

Keywords: animals; eye infection; farms; granulomatosis with polyangiitis; nocardia cyriacigeorgica.

Figure 1. Paranasal sinuses computed tomography demonstrated bilateral otomastoiditis with interval development of severe left maxillary sinus mucosal disease.

Figure 2. Computed tomography of the lungs showing micronodules

Figure 3. Brain and orbit computed tomography scan showing no abnormality in the orbital regions