Pseudomonas scleritis resistant to fourth-generation fluoroquinolones in a patient without prior trauma or surgery.
OBJECTIVE
To describe a case of necrotizing scleritis due to Pseudomonas aeruginosa resistant to fourth-generation fluoroquinolones.


METHODS
Case report. A 50-year-old woman with no history of trauma or surgery presented with pain and redness of the left eye.


RESULTS
The patient did not respond to empiric treatment and developed scleral edema with a nummular area of avascular sclera nasally. Histopathologic examination revealed necrotizing scleritis and cultures grew P. aeruginosa resistant to fourth-generation fluoroquinolones.


CONCLUSIONS
A high index of suspicion for an infectious etiology must be maintained in cases not responding to conventional noninfectious scleritis therapy and in cases with unusual presentations. Resistance to commonly used empiric antibiotics may further complicate the diagnosis and management of infectious scleritis.
University of Utah, Ophthalmology, John Moran Eye Center, Salt Lake City, Utah, USA.
Jay J
JJ
Meyer
Ladan
L
Espandar
Douglas P
DP
Marx
Albert
A
Vitale
Majid
M
Moshirfar
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D004487:Edema / Q000209:etiology; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D009184:Mydriatics / Q000627:therapeutic use; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D019233:Retreatment; D012590:Sclera / Q000098:blood supply / Q000473:pathology; D015422:Scleral Diseases / Q000209:etiology; D015423:Scleritis / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D013256:Steroids / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D009184:Mydriatics; D013256:Steroids