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Case Reports
. 2016 Sep;64(9):674-676.
doi: 10.4103/0301-4738.194330.

Infectious Pseudomonas and Bipolaris scleritis following history of pterygium surgery

Ashkan M Abbey  1 , Nisha V Shah  1 , Richard K Forster  1 , Leejee H Suh  1
Affiliations
Case Reports

Infectious Pseudomonas and Bipolaris scleritis following history of pterygium surgery

Ashkan M Abbey et al. Indian J Ophthalmol. 2016 Sep.

Abstract

We report an interesting case of infectious scleritis from coinfection of Pseudomonas aeruginosa and Bipolaris with no corneal infiltrate. A healthy 60-year-old man with a history of infectious scleritis following pterygium excision presented with purulent material growing P. aeruginosa and 1+ colonies of Bipolaris species of fungus. Broad spectrum treatment was initiated with hourly topical moxifloxacin, fortified tobramycin, and natamycin along with a subconjunctival injection of voriconazole and topical cyclosporine, with PO ketoconazole. After 10 weeks of aggressive empiric treatment, the patient's symptoms had resolved, and his vision returned to baseline although a scleral patch graft was utilized to stabilize scleral thinning.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Slit-lamp photograph of the right eye 2 years after initial presentation, now with an elevated mass of purulence overlying the area of scleral thinning
Figure 2
Figure 2
Gomori methenamine silver stain of purulent area demonstrating numerous branching hyphae (arrow) indicative of fungus
Figure 3
Figure 3
Slit-lamp photograph of the right eye on postoperative month 3 with epithelialization of the scleral patch graft and resolved infection
See this image and copyright information in PMC

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