Endogenous nocardial endophthalmitis in an immunosuppressed patient: A serious warning of an underlying life threatening and blinding disorder

Purpose: to report a case of bilateral endogenous nocardial endophthalmitis with central nervous system involvement in an immunocompromised individual with an extremely poor outcome. case report: a 35-year-old man with a history of long-term,prescribed oral steroid use for membranoproliferative glomerulonephritis presented with profound bilateral vision loss. patient's diagnosis of bilateral endogenous nocardial endophthalmitis was delayed. nocardia was finally isolated from a brain biopsy after a repeat magnetic resonance imaging revealed a brain abscess. with anti-nocardia therapy,patient improved systemically,but the visual outcome was poor,with no light perception in both eyes. conclusion: ocular nocardiosis is a serious vision and life threatening disorder,particularly in patients on immunosuppressive therapy. a high index of suspicion is required for successful treatment.