title: Late-onset intrascleral dissemination of Stenotrophomonas maltophilia scleritis after pterygium excision.
abstract: OBJECTIVE
  To report a case of pterygium excision-related infectious scleritis with late-onset intrascleral dissemination.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 72-year-old female patient was referred for Stenotrophomonas maltophilia scleritis after undergoing pterygium excision 18 years earlier. Surgical debridement and a tectonic corneal patch graft, along with conjunctival flap, were performed to repair the scleral defect after treatment with fortified topical and systemic antibiotics. However, intrascleral dissemination of scleritis occurred 5 months after the initial episode.
  
  
  CONCLUSIONS
  Intrascleral dissemination of S. maltophilia scleritis after pterygium excision might be delayed because of limited invasiveness and inherent resistance to several antibiotics. Long-term follow-up may be needed to protect against the possibility of late-onset intrascleral dissemination.
authors.affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University, Kweishan, Taoyuan, Taiwan. hclinn@adm.cgmh.org.tw
authors.forename: Hsin-Chiung
authors.initials: HC
authors.lastname: Lin
authors.forename: David Hui-Kang
authors.initials: DH
authors.lastname: Ma
authors.forename: Young-Fen
authors.initials: YF
authors.lastname: Chen
authors.forename: Lung-Kun
authors.initials: LK
authors.lastname: Yeh
authors.forename: Ching-Hsi
authors.initials: CH
authors.lastname: Hsiao
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D003646:Debridement; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D011183:Postoperative Complications; D011625:Pterygium / Q000601:surgery*; D012590:Sclera / Q000382:microbiology; D015423:Scleritis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification*; D013524:Surgical Flaps
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin