Pseudomonas scleritis resistant to fourth-generation fluoroquinolones in a patient without prior trauma or surgery.

PURPOSE: To describe a case of necrotizing scleritis due to Pseudomonas aeruginosa resistant to fourth-generation fluoroquinolones.

METHODS

Case report. A 50-year-old woman with no history of trauma or surgery presented with pain and redness of the left eye.

RESULTS

The patient did not respond to empiric treatment and developed scleral edema with a nummular area of avascular sclera nasally. Histopathologic examination revealed necrotizing scleritis and cultures grew P. aeruginosa resistant to fourth-generation fluoroquinolones.

CONCLUSIONS

A high index of suspicion for an infectious etiology must be maintained in cases not responding to conventional noninfectious scleritis therapy and in cases with unusual presentations. Resistance to commonly used empiric antibiotics may further complicate the diagnosis and management of infectious scleritis.