(2016-09) Abbey, Ashkan M; Shah, Nisha V; Forster, Richard K; Suh, Leejee H
We report an interesting case of infectious scleritis from
coinfection of Pseudomonas aeruginosa and Bipolaris with no corneal
infiltrate. A healthy 60‑year‑old man with a history of infectious
scleritis following pterygium excision presented with purulent
material growing P. aeruginosa and 1+ colonies of Bipolaris species
of fungus. Broad spectrum treatment was initiated with hourly
topical moxifloxacin, fortified tobramycin, and natamycin along
with a subconjunctival injection of voriconazole and topical
cyclosporine, with PO ketoconazole. After 10 weeks of aggressive
empiric treatment, the patient’s symptoms had resolved, and his
vision returned to baseline although a scleral patch graft was
utilized to stabilize scleral thinning.