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Scleritis and Streptococcus pneumoniae
A J Altman1, E J Cohen, S T Berger
1Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107.
Cornea
|July 1, 1991
Summary
Streptococcus pneumoniae can cause infectious scleritis, a serious eye infection. Prompt antibiotic treatment is crucial for managing this condition and preserving vision, though outcomes vary.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Scleritis, particularly infectious scleritis, can lead to severe visual impairment.
- Streptococcus pneumoniae is a potential causative agent of infectious scleritis.
Observation:
- This study retrospectively reviewed four patients with Streptococcus pneumoniae scleritis.
- Patient histories included prior beta irradiation, chronic nodular scleritis, and rheumatoid arthritis.
- All patients received intensive intravenous and topical fortified antibiotic therapy.
Findings:
- Two patients achieved good visual acuity (20/30 and 20/60) after treatment.
- One patient developed endophthalmitis, leading to enucleation due to chronic pain.
- Another patient experienced perforation requiring a corneal-scleral graft, resulting in poor visual acuity.
Implications:
- Infectious etiology should be suspected in necrotizing scleritis with purulent discharge.
- Prompt diagnosis with smears and cultures is essential.
- While antibiotic treatment can be effective, severe outcomes like vision loss and enucleation are possible.