Dr.SANKHA SUBHRA CHAUDHURI

Dr. MOUSUMI BANERJEE

Abstract

Nocardia farcinica keratitis is rare. There are only eight reported cases of it in world literature. This is the first case report of Nocardia farcinica keratitis in eastern India. A 36 year old male with a history of foreign body trauma reported with a central corneal ulcer of the right eye. The ulcer was non responding to initial conventional anti-microbial therapy. Microbiological examination revealed thin Gram‐positive branching bacterial bodies with bacilli structures at the branching ends on. Modified acid fast stain showed partially acid fast filamentous bacilli. After 3 days, dry appearing colonies on chocolate agar were seen. The species was confirmed as Nocardia farcinica biochemically by growth at 45°C, and antibacterial resistance to gentamicin but sensitive to amikacin. He was subsequently treated with fortified amikacin (2.5%) hourly. Nocardia diagnosis and management is not difficult if suspected early particularly when it is not responding to conventional therapy.