J Korean Ophthalmol Soc.  2007 Jan;48(1):157-161.

A Case of Methicillin Resistant Staphylococcus Aureus Scleritis after Pterygium Excision

• Park SW
• Lee MH
• Lee JE
• Lee JS

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.

Keyword

Methicillin resistant Staphylococcus aureus; Pterygium; Scleritis

MeSH Terms

Amikacin
Anti-Bacterial Agents
Ceftazidime
Debridement
Humans
Inflammation
Methicillin Resistance*
Methicillin*
Methicillin-Resistant Staphylococcus aureus
Pterygium*
Recurrence
Scleritis*
Staphylococcus aureus*
Staphylococcus*
Transplants
Vancomycin
Amikacin
Anti-Bacterial Agents
Ceftazidime
Methicillin
Vancomycin