title: Scleritis and Streptococcus pneumoniae.
abstract: We retrospectively review our experience with four patients with Streptococcus pneumoniae scleritis. Two of the patients had been exposed to beta irradiation after pterygium removal 4 and 13 years previously. One patient had a 3-year history of chronic anterior nodular scleritis, and one patient had severe rheumatoid arthritis. All were treated with intensive i.v. and topical fortified antibiotics. In two of the cases, the infection was controlled and visual acuity returned to 20/30 and 20/60. In one patient, infectious scleritis progressed to endophthalmitis. This eye ultimately became phthisical and required enucleation because of chronic pain. In the remaining patient, infectious scleritis led to perforation, which required a corneal-scleral patch graft. This patient had a final visual acuity of counting fingers. An infectious etiology should be suspected in cases of necrotizing scleritis associated with a purulent discharge, and appropriate smears and cultures should be obtained. Infectious scleritis can be caused by streptococcal organisms. Appropriate topical and intravenous antibiotic treatment is effective in some cases.
authors.affiliation: Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107.
authors.forename: A J
authors.initials: AJ
authors.lastname: Altman
authors.forename: E J
authors.initials: EJ
authors.lastname: Cohen
authors.forename: S T
authors.initials: ST
authors.lastname: Berger
authors.forename: B J
authors.initials: BJ
authors.lastname: Mondino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy; D012189:Retrospective Studies; D015423:Scleritis / Q000188:drug therapy / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents