Shirai Hospital, Kagawa, Japan.
J Ocul Pharmacol Ther. 2011 Aug;27(4):415-8. doi: 10.1089/jop.2011.0043. Epub 2011 Jun 20.
To report a case of necrotizing nocardial scleritis treated with surgical debridement and topical polyvinyl alcohol iodine (PAI) and antibiotics.
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.
Necrotizing nocardial scleritis can be treated by surgical debridement and systemic TMP-SMX and topical PAI.
报告一例经手术清创及局部聚乙烯醇碘（PVA 碘）和抗生素治疗的坏死性奴卡氏菌性巩膜炎病例。
一名 78 岁男性左眼行白内障超声乳化吸除联合人工晶状体植入术。术后 2 个月，患者恢复顺利，但随后出现感染性巩膜炎。患者接受了强化抗生素治疗，但病变未得到缓解。由于治疗反应不佳，怀疑为奴卡菌感染，病变部位反复刮除，并给予患者全身甲氧苄啶/磺胺甲噁唑（TMP-SMX，800mg/天）和局部 PVA 碘（0.033%，4 次/天）治疗。刮取物培养出奴卡菌。治疗后感染完全消退。
坏死性奴卡氏菌性巩膜炎可通过手术清创、全身应用 TMP-SMX 和局部应用 PVA 碘治疗。
