RESUMO
PURPOSE: To report a case of Nocardia cyriacigeorgica endophthalmitis. METHODS: Case report. RESULTS: A 71-year-old man on long-term steroid therapy for poor respiratory function from lung carcinoma and presumed recent liver metastases presented with a four week history of blurry vision in the left eye. Ophthalmic examination revealed a white elevated mass in the macula with hemorrhage, concerning for metastasis. The patient was treated for presumed ocular metastases but had poor response to radiotherapy and was diagnosed four weeks later with N. cyriacigeorgica by retinal biopsy. Despite intravitreal and systemic antibiotics, the patient had progression of disease and died of respiratory involvement. CONCLUSION: Nocardia endogenous endophthalmitis can present as a mass retinal lesion in immunosuppressed patients with metastatic disease. Early vitreous and retinal biopsy may be required for definitive diagnosis and treatment. A pulmonary source of infection should be suspected and monitored closely.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/complicações , Endoftalmite/microbiologia , Neoplasias Pulmonares/complicações , Nocardiose/microbiologia , Nocardia/isolamento & purificação , Idoso , Diagnóstico Diferencial , Evolução Fatal , Humanos , MasculinoRESUMO
Erdheim-Chester disease is a rare infiltrative disorder of non-Langerhans cell histiocytes, which affects multiple organs, including bone, heart, lungs, orbits, central nervous system (CNS), pituitary gland, and retroperitoneum. Bone affliction is almost universal in these patients and, to a lesser degree, the CNS, retroperitoneum, and other tissues. Eye involvement is typically retro-orbital or periorbital. This case report describes a 48-year-old patient who presented with reduced vision in the left eye and no other complaints. Fundus examination revealed a choroidal mass in the macula. The authors believe that this might be the second case of choroidal involvement in Erdheim-Chester disease.
