A Case of Methicillin Resistant Staphylococcus Aureus Scleritis after Pterygium Excision.

Park, Sung Who; Lee, Min Ho; Lee, Ji Eun; Lee, Jong Soo

Case Report

Journal of the Korean Ophthalmological Society 2007;48(1):157-161.
Published online January 31, 2007.

A Case of Methicillin Resistant Staphylococcus Aureus Scleritis after Pterygium Excision.

Sung Who Park, Min Ho Lee, Ji Eun Lee, Jong Soo Lee

Department of Ophthalmology, Pusan National Unversity Hospital, Pusan, Korea. lorenzo-lee@hanmail.net

익상편 수술 후 발생한 메티실린 저항 황색 포도상구균

박성후,이민호,이지은,이종수

Department of Ophthalmology, Pusan National Unversity Hospital, Pusan, Korea

Correspondence: Sung Who Park, M.D.

Abstract

PURPOSE
To report a case, which developed after pterygium excision, of methicillin-resistant Staphylococcus aureus (MRSA) scleritis, for which the patient was treated with antibiotics, debridement, and a scleral graft. METHODS: During the application of topical and systemic steroid, because of necrotizing scleritis after pterygium excision, infectious signs were noted. Although the empirical antibiotic treatment with amikacin and ceftazidime was used topically and systemically, no improvement was observed. MRSA was identified by scleral culture, and topical and systemic vancomycin were applied. RESULTS: By one week after beginning vancomycin therapy, the lesion had improved. Over the next seven days, scleral inflammation diminished, and infectious signs regressed. Surgery adding a scleral patch graft and sliding conjunctival flap was performed, and no complications or recurrences were found until eight months postoperatively. CONCLUSIONS: In cases of necrotizing scleritis treated with steroid, it should be carefully observed whether there is combined infectious scleritis. If infectious scleritis is resistant to empirical antibiotics, then it should be considered that MRSA can be etiological agent.

Key Words: Methicillin resistant Staphylococcus aureus;Pterygium;Scleritis