Ocular immunology and inflammation · 2011
Infectious scleritis after subtenon triamcinolone acetonide injection.
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Gharaee Hamid, Khalife Mohammad, Poor Setareh Sagheb Hossein, Abrishami Mojtaba
Аннотация
PURPOSE: To report a case of Staphylococcus epidermidis infection after subtenon injection (STI) of triamcinolone acetonide (TA).
DESIGN: Interventional case report.
METHODS: A 20-year-old patient with corneal graft rejection received STI of TA after insufficient response to topical and oral corticosteroids.
RESULTS: After conjunctival necrosis, necrotizing scleritis progressed although topical and systemic steroids were discontinued. Systemic ciprofloxacin, topical fortified amikacin, and vancomycine drops were used. Complete recovery was obtained after 3 weeks. Smears and cultures showed Staphylococcus epidermidis infection.
CONCLUSIONS: Although uncommon, infectious scleritis can occur following uncomplicated subconjunctival corticosteroid injections. Infectious scleritis can be very difficult to diagnose as it may mimic an immune mediated disease. If the conjunctiva is suspected to be involved, a smear should always be taken. Prevention by sterilizing the injection site (prep and drape) and strong antibiotic prophylaxis are recommended to reduce the risk of the infectious scleritis.
DESIGN: Interventional case report.
METHODS: A 20-year-old patient with corneal graft rejection received STI of TA after insufficient response to topical and oral corticosteroids.
RESULTS: After conjunctival necrosis, necrotizing scleritis progressed although topical and systemic steroids were discontinued. Systemic ciprofloxacin, topical fortified amikacin, and vancomycine drops were used. Complete recovery was obtained after 3 weeks. Smears and cultures showed Staphylococcus epidermidis infection.
CONCLUSIONS: Although uncommon, infectious scleritis can occur following uncomplicated subconjunctival corticosteroid injections. Infectious scleritis can be very difficult to diagnose as it may mimic an immune mediated disease. If the conjunctiva is suspected to be involved, a smear should always be taken. Prevention by sterilizing the injection site (prep and drape) and strong antibiotic prophylaxis are recommended to reduce the risk of the infectious scleritis.
Предметные рубрики MeSH
Administration, TopicalAmikacinAnti-Bacterial AgentsAnti-Infective AgentsCiprofloxacinCorneal TransplantationDrug Therapy, CombinationHumansImmunosuppressive AgentsInjections, IntraocularMaleNecrosisOphthalmic SolutionsScleritisStaphylococcal InfectionsStaphylococcus epidermidisTenon CapsuleTriamcinolone AcetonideVancomycinYoung Adult