AUTHOR=Liu Chang , Zhang Lei , Liu Lili , Wang Ye , Cui Yanhui , Liang Tianwei , Chen Tianming , Jiang Yongqiang , Liu Gang , Li Li 

TITLE=Case Report: First Case of Endophthalmitis Caused by an Emerging Pathogen: Nocardia huaxiensis

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.933851

DOI=10.3389/fpubh.2022.933851

ISSN=2296-2565

ABSTRACT=Nocardia endophthalmitis is a relatively uncommon form of endophthalmitis seen in clinical patients. In general, Nocardia endophthalmitis tends to carry a poor prognosis. Here, we report a 3-year-old child that was admitted to the hospital due to a rupture of the left eye. The suturing and anterior chamber formation were performed immediately. Sixteen days after the operation, massive whitish plump and tufted exudates gathered in the pupil area and at the bottom of the anterior chamber, and the child was diagnosed with endophthalmitis. The infection was initially considered to be caused by fungal pathogens for that the hyphae and spores were observed in the smear. However, the isolate obtained after 4 days of culturation was identified as actinomycetes using MALDI-TOF. We further classified it as Nocardia huaxiensis by next-generation sequencing (NGS) based on MinION platform. Amikacin and sulfamethoxazole tablets were used to control the infection and the ocular inflammation gradually subsided. Intraocular lens (IOL) implantation is planned to be performed at an appropriate future time to improve his vision. Nocardia endophthalmitis is rare and usually caused by ocular trauma or surgery. In conclusion, Nocardia huaxiensis should be considered as an emerging pathogen and deserves more attention.