Acute post-operative panophthalmitis by Nocardia otitidiscaviarum: A rare presentation

Nocardia species are infrequently associated with ocular conditions, such as keratitis, dacryocystitis, endophthalmitis, and orbital cellulitis, particularly related to ocular trauma involving vegetative matter. Their incidence in acute-onset post-operative endophthalmitis is rarely documented. We discuss a 65-year-old diabetic female patient who presented with acute-onset vision loss, with corneal perforation and panophthalmitis two weeks following cataract surgery. Evisceration had to be performed. The culture of ocular contents revealed the presence of Nocardia otitidiscaviarum , identified by MALDI-TOF MS. The case highlights the importance of microbiological diagnostics and antimicrobial susceptibility testing, coupled with early intervention in the management of acute-onset post-cataract surgery panophthalmitis.