Bilateral surgically induced necrotising scleritis with secondary superinfection

• Published in: British journal of ophthalmology Vol. 89; no. 1; pp. 124 - 125
• Main Authors: Vagefi, M R, Hollander, D A, Seitzman, G D, Margolis, T P
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.01.2005; BMJ Publishing Group LTD; Copyright 2005 British Journal of Ophthalmology
• Subjects: Aged; bare sclera; Cardiovascular disease; Diabetic retinopathy; Gangrene; Health risk assessment; Humans; Letter; Male; necrotising scleritis; Pain; Patients; Phacoemulsification - adverse effects; Postoperative Complications - microbiology; Pterygium - surgery; pterygium excision; Scleritis - microbiology; Streptococcal Infections - microbiology; Streptococcus infections; Superinfection - microbiology
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2004.051359

Case report A 66 year old Samoan male, with type II diabetes, end stage renal disease, coronary artery disease, and gout underwent uncomplicated combined phacoemulsification and bare sclera pterygium excision (without antimetabolites) in the right eye, followed 1 month later by the same combined procedure in the left eye. An extensive laboratory evaluation for systemic aetiologies of scleral necrosis was unrevealing except for a mildly elevated rheumatoid factor of 62 IU/ml (normal <40 IU/ml.) Culture results demonstrated a bilateral polymicrobial infection, with Streptococcus pneumoniae and Streptococcus viridans in the right eye, and Streptococcus pneumoniae, Streptococcus viridans, and Haemophilus influenzae in the left eye.