J Korean Ophthalmol Soc.  2015 Oct;56(10):1646-1649. 10.3341/jkos.2015.56.10.1646.

A Case of Pseudomonas aeruginosa Infection after Scleral Buckling for Retinal Detachment

Affiliations
  • 1Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea. youngjoon@cnu.ac.kr

Abstract

PURPOSE
To report a case of Pseudomonas aeruginosa infection after scleral buckling for retinal detachment.
CASE SUMMARY
A 68-year-old male presented with a 2-day history of pain in the right eye. The patient had a history of scleral buckling for retinal detachment 10 years earlier and excisional biopsy for conjunctival mass 1 month previously. Biopsy revealed chronic inflammation and granulation tissue formation. Slit-lamp examinations revealed superior conjunctival injection, edema and exposed suture knot. Fundus examination revealed exudative retinal detachment and choroidal detachment. The conjunctival lesion did not improve although the patient was treated with moxifloxacin. After 4 days, bacterial and fungal cultures were performed because the conjunctiva presented with purulent discharge 4 days after treatment. The scleral buckle and suture knot were removed. The cultures revealed growth of Pseudomonas aeruginosa. According to antibiotic sensitivity test results, the authors treated the patient with ceftazidime. The conjunctival lesion, choroidal detachment and exudative retinal detachment were improved.
CONCLUSIONS
In patients with conjunctival injection, edema, purulent discharge and ocular pain after scleral buckling, presence of infection should be suspected. If scleral buckle infection is suspected, bacterial culture, antibiotics treatment and scleral buckle removal should be considered.

Keyword

Infection; Pseudomonas aeruginosa; Retinal detachment; Scleral buckle

MeSH Terms

Aged
Anti-Bacterial Agents
Biopsy
Ceftazidime
Choroid
Conjunctiva
Edema
Granulation Tissue
Humans
Inflammation
Male
Pseudomonas aeruginosa*
Pseudomonas*
Retinal Detachment*
Retinaldehyde*
Scleral Buckling*
Sutures
Anti-Bacterial Agents
Ceftazidime
Retinaldehyde

Figure

  • Figure 1. Anterior segment photograph of the right eye show-ing chemosis and injection of the conjunctiva with whitish ele-vated lesions and purulent discharge.

  • Figure 2. Gross photograph of removed scleral explant. The darkened area is suspected of pseudomonas infection.

  • Figure 3. Three days after scleral explant removal. Anterior segment photograph shows the melted conjunctiva and visible uveal tissue through the melted sclera.

  • Figure 4. Three months after scleral explant removal. Anterior segment photograph shows mild conjunctival injection and scleral thinning.


Reference

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