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Nocardia asteroides keratitis in south India.

AbstractPURPOSE:
To determine the risk factors, microbiological features, clinical features and other epidemiological characteristics of Nocardia keratitis seen at a tertiary eye care centre in south India.
METHODS:
We evaluated 31 patients with Nocardia keratitis seen over two years, from September 1999 to September 2001. Corneal scrapings were subjected to microscopy and culture using standard protocols.
RESULTS:
Out of 2184 corneal ulcers cultured, 31(1.42%) were found to be Nocardia asteroides. All 31(100%) were detected correctly by 10% potassium hydroxide wet mount preparation. The highest percentage of isolates was susceptible to gentamicin(100%) followed by ciprofloxacin(93.55%). Twenty four (77.42%) patients were from rural areas; 22(70.97%) were agricultural workers; 29(93.55%) had history of trauma; 2(6.45%) had previous ocular surgery; 28(90.32%) had ocular injury with soil and sand; and 22(70.97%) had ocular injury while working in the agricultural fields. Ten (32.26%) patients presented at our institute between 15 to 35 days of onset of illness, 26(83.87%) had previous medical treatment, and 15(48.39%) patients had used traditional eye medicines. The average age of the patients was 46.16 years, with a range of 11 to 75 years. No seasonal variation was observed.
CONCLUSIONS:
A high index of suspicion of Nocardia infection should exist in patients with a history of trauma to the eye by soil or sand. The organisms are sensitive to commonly used topical ocular antibiotics.
AuthorsM J Bharathi, R Ramakrishnan, S Vasu, Meenakshi, A Chirayath, R Palaniappan
JournalIndian journal of medical microbiology (Indian J Med Microbiol) 2003 Jan-Mar Vol. 21 Issue 1 Pg. 31-6 ISSN: 0255-0857 [Print] United States
PMID17642971 (Publication Type: Journal Article)

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