Necrotizing nocardial scleritis successfully treated with surgical debridement and topical polyvinyl alcohol iodine and antibiotics.

Abstract

PURPOSE:

To report a case of necrotizing nocardial scleritis treated with surgical debridement and topical polyvinyl alcohol iodine (PAI) and antibiotics.

CASE:

A 78-year-old man underwent phacoemulsification with intraocular lens implantation in the left eye. He had an uncomplicated postoperative course for 2 months but then developed infectious scleritis. The patient received intensive antibiotics treatments; however, the lesion did not respond. Because of the poor response, Nocardia infection was suspected, and the lesion was repeatedly scraped and the patient was treated with systemic trimethoprim/sulfamethoxazole (TMP-SMX, 800 mg/day) and topical PAI (0.033%, 4 times/day). Cultures of the scrapings grew Nocardia. The treatment led to a complete resolution of the infection.

CONCLUSIONS:

Necrotizing nocardial scleritis can be treated by surgical debridement and systemic TMP-SMX and topical PAI.

• Authors: Hirohisa Maruo, Atsushi Shiraishi, Yuko Hara, Yoko Maruo, Yuichi Ohashi
• Journal: Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics (J Ocul Pharmacol Ther) Vol. 27 Issue 4 Pg. 415-8 (Aug 2011) ISSN: 1557-7732 [Electronic] United States
• PMID: 21689016 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Trimethoprim, Sulfamethoxazole Drug Combination
• Polyvinyl Alcohol
• Iodine

Topics

• Aged
• Anti-Bacterial Agents (therapeutic use)
• Combined Modality Therapy
• Debridement (methods)
• Humans
• Iodine (administration & dosage, chemistry)
• Male
• Nocardia Infections (microbiology, pathology, therapy)
• Polyvinyl Alcohol (administration & dosage, chemistry)
• Scleritis (microbiology, pathology, therapy)
• Treatment Outcome
• Trimethoprim, Sulfamethoxazole Drug Combination (therapeutic use)