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 ORIGINAL ARTICLE
Year : 2003  |  Volume : 21  |  Issue : 1  |  Page : 31-36

Nocardia asteroides keratitis in South India


1 Department of Microbiology, Aravind Eye Care System, Arvind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli - 627 001, Tamilnadu, India
2 Cornea Services, Aravind Eye Care System, Arvind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli - 627 001, Tamilnadu, India
3 Department of Microbiology, Sri Paramakalyani College, Alwarkuruchi, Tirunelveli - 627 412, Tamilnadu, India

Correspondence Address:
M J Bharathi
Department of Microbiology, Aravind Eye Care System, Arvind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli - 627 001, Tamilnadu
India
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Source of Support: None, Conflict of Interest: None


PMID: 17642971

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PURPOSE: 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.






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2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

Online since April 2001, new site since 1st August '04