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NOCARDIA CHOROIDAL ABSCESS Risk Factors, Treatment Strategies, and Visual Outcomes

机译：NOCARDIA CHOROIDAL ACCESS危险因素，治疗策略和视觉结果

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Purpose:To describe the risk factors, clinical course, ancillary test findings, treatment strategies, and visual outcomes of a series of patients with choroidal abscesses caused by endogenous Nocardia.Methods:This retrospective, consecutive noncomparative case series included all patients with Nocardia ocular infections at 3 tertiary medical centers over the past 20 years.Results:Five eyes in 5 patients were identified with choroidal abscesses because of Nocardia. All patients were immunocompromised: one suffered from AIDS and four had autoimmune disorders. Three of the 5 patients (60%) underwent systemic evaluation, and in all 3, nonocular nocardiosis was identified. Four patients (80%) underwent diagnostic ophthalmic surgery and received systemic and intravitreal antibiotics. The final patient deferred these interventions. Outcomes at the last follow-up examination were 20/25, 1/200, hand motion at 1 foot, and 2 patients underwent enucleation. Mean follow-up (standard deviation) was 159 (+/- 103) days.Conclusion:Immunosuppression is the most significant risk factor for developing Nocardia choroidal abscesses. Definitive diagnosis generally requires subretinal biopsy, which is also critical to implementing appropriate antibiotic therapy.
机译：目的：描述一系列由内源性诺卡氏菌引起的脉络膜脓肿患者的危险因素，临床病程，辅助检查结果，治疗策略和视觉结果。方法：该回顾性连续非对照病例系列包括所有诺卡氏菌眼感染患者在过去20年中，在3个三级医疗中心进行了研究。结果：5例患者的五只眼因诺卡氏菌而被识别出脉络膜脓肿。所有患者均免疫功能低下：一名患有艾滋病，四名患有自身免疫性疾病。 5例患者中有3例（60％）进行了系统评估，并且在所有3例中，均确定为非眼性心肌病。四名患者（80％）接受了眼科诊断手术，并接受了全身和玻璃体内抗生素治疗。最后的病人推迟了这些干预。上次随访检查的结果为20 / 25、1 / 200、1英尺的手部运动以及2例行摘除术的患者。平均随访（标准差）为159（+/- 103）天。结论：免疫抑制是发生诺卡氏脉络膜脓肿的最重要危险因素。明确的诊断通常需要视网膜下活检，这对于实施适当的抗生素治疗也至关重要。

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