Recurrent scleral abscess after uncomplicated cataract extraction.
OBJECTIVE
To report the unusual occurrence of a recurrent scleral abscess after uncomplicated cataract extraction.


METHODS
Case report of a 77-year-old healthy woman.


RESULTS
Multiple cultures and antibiotic treatments failed to resolve presenting symptoms. Gram stain, Gomori methenamine silver (GMS) stain, and all cultures were negative. After drainage of the abscess, the patient's symptoms cleared briefly, then returned 6 months later showing a positive GMS stain consistent with Candida. The patient was treated with amphotericin, natamycin, and fluconazole at this time, and a return in visual acuity occurred along with a resolution of symptoms. No re-occurrence has been noted with 2.5 years of follow-up.


CONCLUSIONS
Cataract extraction, although generally a safe procedure, can still result in unusual complications such as scleral abscesses. Excellent outcomes are possible once the infections are identified and treated.
Goldstein
Michael H
MH
Department of Ophthalmology, Tufts University School of Medicine, and New England Eye Center, 750 Washington Street, Boston, MA 02111, USA. MGoldstein1@tufts-nemc.org
Lim
Mira
M
Driebe
William T
WT
D000038:Abscess / Q000209:etiology* / Q000382:microbiology* / Q000473:pathology; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy; D002387:Cataract Extraction / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D010866:Natamycin / Q000627:therapeutic use; D012008:Recurrence; D015422:Scleral Diseases / Q000209:etiology* / Q000382:microbiology* / Q000473:pathology
D000935:Antifungal Agents; D000666:Amphotericin B; D010866:Natamycin; D015725:Fluconazole