翼状胬肉手术后广泛耐药性感染性巩膜炎的成功治疗。

Successful Management of Extensively Drug Resistant -Infectious Scleritis after Pterygium Surgery.

机构信息

Cornea Service, The Cornea Institute, L V Prasad Eye Institute, Hyderabad, India.

Jhaveri Microbiology Center, L. V. Prasad Eye Institute, Hyderabad, India.

出版信息

Ocul Immunol Inflamm. 2024 Sep;32(7):1279-1283. doi: 10.1080/09273948.2023.2232037. Epub 2023 Jul 11.

DOI:10.1080/09273948.2023.2232037

PMID:37433154

Abstract

INTRODUCTION AND PURPOSE

We report a case of extensively drug-resistant (XDR) (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 , 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.

摘要

介绍和目的

我们报告了一例翼状胬肉手术后广泛耐药（XDR）（PA）巩膜炎。

方法

病例报告。

结果

一位 58 岁的农民在另一家医院行翼状胬肉切除术 40 天后，出现严重疼痛、肿胀和视力模糊。患者正在服用多种药物，但没有缓解。检查显示右眼鼻侧巩膜变薄，伴有溃疡和浸润。微生物学显示，仅对黏菌素显示中度敏感。患者给予局部（0.19%）和静脉注射黏菌素和地塞米松。症状迅速缓解，在接下来的 2 个月内病变愈合。