{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:28:34Z","timestamp":1790774914098,"version":"4.1.0"},"reference-count":25,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,9,30]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>We report a case of subretinal abscess as the initial presentation of systemic nocardiosis. The patient was a known case of chronic inflammatory demyelinating polyneuropathy and on long-term immunosuppressants. He presented with a rapidly progressive, unilateral decline in visual acuity in the right eye. Dilated fundus examination showed a large whitish subretinal lesion. A working diagnosis of subretinal abscess was made. The appearance was highly suspicious for <jats:italic>Nocardia<\/jats:italic> abscess. On further direct questioning, it was noted that the patient had been experiencing low-grade fever and non-productive cough for 1\u2009month. The patient was referred to infectious diseases for systemic work-up and a vitreous tap was done, along with intravitreal antibiotics. Blood culture and bronchoalveolar lavage both reported <jats:italic>Nocardia<\/jats:italic> species. Sensitivity-guided antibiotic therapy resulted in improved systemic condition and a quiet and comfortable right eye, but vision could not be saved due to late presentation.<\/jats:p>","DOI":"10.1136\/bcr-2020-236898","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T16:05:34Z","timestamp":1604333134000},"page":"e236898","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Subretinal abscess as an initial presentation of systemic nocardiosis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6575-2989","authenticated-orcid":false,"given":"Muhammad Bilal","family":"Malik","sequence":"first","affiliation":[{"name":"Section of Ophthalmology, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nida Jawed","family":"Ahsan","sequence":"additional","affiliation":[{"name":"Section of Ophthalmology, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Hilal","sequence":"additional","affiliation":[{"name":"Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Faisal","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5100-3189","authenticated-orcid":false,"given":"M A Rehman","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Section of Ophthalmology, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,2]]},"reference":[{"key":"2025082803552111000_13.11.e236898.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2014.06.002"},{"key":"2025082803552111000_13.11.e236898.2","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1038\/eye.2017.284","article-title":"A British Ophthalmological surveillance unit study on metastatic endogenous endophthalmitis","volume":"32","author":"Maling","year":"2018","journal-title":"Eye"},{"key":"2025082803552111000_13.11.e236898.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/261310","article-title":"An eleven-year retrospective study of endogenous bacterial endophthalmitis","volume":"2015","author":"Nishida","year":"2015","journal-title":"J Ophthalmol"},{"key":"2025082803552111000_13.11.e236898.4","doi-asserted-by":"crossref","first-page":"134","DOI":"10.3928\/23258160-20170130-07","article-title":"Clinical Features and Management of Subretinal Abscesses Secondary to Methicillin-Resistant Staphylococcus aureus Endogenous Endophthalmitis","volume":"48","author":"Fortun","year":"2017","journal-title":"Ophthalmic Surg Lasers Imaging Retina"},{"key":"2025082803552111000_13.11.e236898.5","doi-asserted-by":"publisher","DOI":"10.1086\/657399"},{"key":"2025082803552111000_13.11.e236898.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(00)00355-X"},{"key":"2025082803552111000_13.11.e236898.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0420.2007.00982.x"},{"key":"2025082803552111000_13.11.e236898.8","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.10.4497-4501.2003"},{"key":"2025082803552111000_13.11.e236898.9","unstructured":"Brown J . 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