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Successful Management of Extensively Drug Resistant Pseudomonas aeruginosa-Infectious Scleritis after Pterygium
Samruddhi Dalal1, Somasheila I Murthy1, Ketan Deogaokar1
1Cornea Service, The Cornea Institute, L V Prasad Eye Institute, Hyderabad, India.
Introduction And Purpose:
We report a case of extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) scleritis after pterygium surgery.
Methods:
Case report.
Results:
A 58-year-old farmer presented with a 40-day history of severe pain, swelling, and blurred vision after a pterygium excision was performed at another institute. The patient was on multiple medications with no relief. The examination showed a nasally located scleral thinning in his right eye, with ulceration and infiltrates. Microbiology revealed Pseudomonas aeruginosa, which showed intermediate sensitivity to colistin only. The patient was administered topical (0.19%) and intravenous colistin and dexamethasone. There was a rapid reduction in symptoms, and the lesions healed over the next 2 months.
Conclusions:
To the best of our knowledge, this is the first case report of XDR-PA scleritis. We suggest the possibility of evolving drug resistance caused by the iatrogenic use of antibiotics during the early stages of the disease course.
Insights
This case report details extensively drug-resistant Pseudomonas aeruginosa scleritis following pterygium surgery. Prompt treatment with colistin and dexamethasone led to successful healing.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Pterygium surgery can lead to postoperative complications.
- Scleritis is a serious ocular inflammation that can impair vision.
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