Rapid species determination of Nocardia keratitis using pyrosequencing technology

PURPOSE: To describe a new technique, pyrosequencing, which allows for the rapid identification of Mycobacterium and Nocardia species. DESIGN: Interventional case report. METHODS: The medical records of a patient presenting with an infectious keratitis were reviewed. RESULTS: A case of Nocardia abscessus/arthrititis/asiatica keratitis was diagnosed in a young individual with the aid of pyrosequencing technology. Based on presumed antibiotic sensitivities, therapy with topical trimethoprim-sulfamethoxazole eyedrops was initiated, and the infection was cleared rapidly with minimal residual scarring. CONCLUSIONS: Pyrosequencing may be a useful tool in aiding the rapid diagnosis and treatment of ocular infections caused by slow-growing pathogens.