title: Infectious scleritis after pars plana vitrectomy because of methicillin-resistant Staphylococcus aureus resistant to fourth-generation fluoroquinolones.
abstract: OBJECTIVE
  To describe a case of infectious scleritis caused by methicillin-resistant Staphylococcus aureus (MRSA) after pars plana vitrectomy despite treatment with topical fourth-generation fluoroquinolones.
  
  
  METHODS
  Single interventional case report.
  
  
  RESULTS
  A 72-year-old man presented with scleral thinning and subconjunctival abscess 1 month after pars plana vitrectomy. Microbiological studies including cultures and antibiotic sensitivity were performed. Culture of the scleral abscess showed growth of MRSA resistant to fourth-generation fluoroquinolones and sensitive to vancomycin and erythromycin. Treatment with a combination of topical vancomycin and systemic erythromycin for 6 weeks resolved the infectious scleritis.
  
  
  CONCLUSIONS
  MRSA can be a cause of infectious scleritis after ocular surgery without a clear source despite surgical prophylaxis with topical fourth-generation fluoroquinolones.
authors.affiliation: Department of Ophthalmology and Vision Science, University of California, Davis Medical Center, Sacramento, CA 95817, USA. vfeiz@ucdavis.edu
authors.forename: Vahid
authors.initials: V
authors.lastname: Feiz
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Redline
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000627:therapeutic use; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D024841:Fluoroquinolones / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D015423:Scleritis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D014640:Vancomycin / Q000627:therapeutic use; D014821:Vitrectomy / Q000009:adverse effects*
chemical_list: D000893:Anti-Inflammatory Agents; D024841:Fluoroquinolones; D004917:Erythromycin; D014640:Vancomycin