A 70-Year-Old Man with Progressive Eye Redness, Pain, and Visual Loss

Nocardia species are gram-positive, filamentous, branching bacteria that are found in water, soil, dust, and decaying vegetation. Infection of the eye with Nocardia may cause keratitis, scleritis, or endophthalmitis. A 70-year-old man presented with progressive left eye redness associated with pain, blurry vision, excessive tearing, and photophobia. An ophthalmologic examination was significant for scleral necrosis and thinning as well as a large corneal infiltrate. The patient was subsequently diagnosed with sclerokeratitis. Fungal cultures obtained from the cornea grew Nocardia abscessus complex/Nocardia exalbida. This case demonstrates that Nocardia should be included in the differential diagnosis of sclerokeratitis.