title: Necrotizing nocardial scleritis successfully treated with surgical debridement and topical polyvinyl alcohol iodine and antibiotics.
abstract: OBJECTIVE
  To report a case of necrotizing nocardial scleritis treated with surgical debridement and topical polyvinyl alcohol iodine (PAI) and antibiotics.
  
  
  METHODS
  A 78-year-old man underwent phacoemulsification with intraocular lens implantation in the left eye. He had an uncomplicated postoperative course for 2 months but then developed infectious scleritis. The patient received intensive antibiotics treatments; however, the lesion did not respond. Because of the poor response, Nocardia infection was suspected, and the lesion was repeatedly scraped and the patient was treated with systemic trimethoprim/sulfamethoxazole (TMP-SMX, 800 mg/day) and topical PAI (0.033%, 4 times/day). Cultures of the scrapings grew Nocardia. The treatment led to a complete resolution of the infection.
  
  
  CONCLUSIONS
  Necrotizing nocardial scleritis can be treated by surgical debridement and systemic TMP-SMX and topical PAI.
authors.affiliation: Shirai Hospital, Kagawa, Japan. oomaru@hotmail.co.jp
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Maruo
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiraishi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hara
authors.forename: Yoko
authors.initials: Y
authors.lastname: Maruo
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods*; D006801:Humans; D007455:Iodine / Q000008:administration & dosage / Q000737:chemistry; D008297:Male; D009617:Nocardia Infections / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D011142:Polyvinyl Alcohol / Q000008:administration & dosage / Q000737:chemistry; D015423:Scleritis / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D011142:Polyvinyl Alcohol; D007455:Iodine