Nocardia brasiliensis Endophthalmitis in a Patient with an Exposed Ahmed Glaucoma Drainage Implant

Purpose: To report a case of endophthalmitis due to Nocardia brasiliensis in an eye with an exposed, infected Ahmed glaucoma drainage implant (GDI). Design: Retrospective case report. Methods: A patient with an exposed GDI experienced recurrent episodes of endophthalmitis despite repeated intravitreal injections of antibiotics and steroids. The tube was initially repositioned and finally removed. Results: Whereas repeated cultures from the anterior chamber and vitreous were negative, cultures from the removed tube grew Nocardia brasiliensis. Despite oral trimethoprim-sulfamethoxazole and intravitreal amikacin the eye became phthisical and lost light perception. Conclusions: An exposed GDI may lead to endophthalmitis due to Nocardia brasiliensis and may require explantation to establish a diagnosis.