Infectious surgically induced necrotising scleritis presenting 10 years post-pterygium excision: a case report

Ru Jian Jonathan Teoh, Binti Ayob Siti Aeisyah, Y. P. Lai, Alias Rohanah
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Abstract

Background: Surgically induced necrotizing scleritis (SINS) is a rare sequela that may occur after ocular surgery. We report a case of infectious SINS as a complication of pterygium excision. Case presentation: A 75-year-old man had undergone pterygium excision in the right eye and developed infectious SINS 10 years post-surgery. The sclera adjacent to the previous site of pterygium excision showed significant thinning with uveal show, complicated with signs of infection including purulent discharge, necrotic sclera, and hypopyon. Conjunctival swab culture yielded Pseudomonas aeruginosa. Blood investigations demonstrated positive rheumatoid factor. The patient was successfully treated with a 2-week course of systemic and topical antibiotics with topical steroid. Conclusion: SINS may develop post-pterygium excision. Early diagnosis and intervention prevent progression and further complications.
翼状胬肉切除术后 10 年出现的感染性手术诱发坏死性巩膜炎:病例报告
背景:手术诱发坏死性巩膜炎(SINS)是眼科手术后可能出现的一种罕见后遗症。我们报告了一例翼状胬肉切除术并发感染性 SINS 的病例。 病例介绍:一名 75 岁的男性接受了右眼翼状胬肉切除术,术后 10 年出现了感染性 SINS。与之前翼状胬肉切除术部位相邻的巩膜明显变薄,出现葡萄膜显示,并伴有感染症状,包括脓性分泌物、坏死巩膜和眼睑下垂。结膜拭子培养出铜绿假单胞菌。血液检查显示类风湿因子呈阳性。患者接受了为期两周的全身和局部抗生素以及局部类固醇激素治疗,并取得了成功。 结论翼状胬肉切除术后可能出现 SINS。早期诊断和干预可预防病情恶化和进一步的并发症。
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