Infectious scleritis after pars plana vitrectomy because of methicillin-resistant Staphylococcus aureus resistant to fourth-generation fluoroquinolones

Cornea. 2007 Feb;26(2):238-40. doi: 10.1097/


Purpose: To describe a case of infectious scleritis caused by methicillin-resistant Staphylococcus aureus (MRSA) after pars plana vitrectomy despite treatment with topical fourth-generation fluoroquinolones.

Methods: Single interventional case report.

Results: A 72-year-old man presented with scleral thinning and subconjunctival abscess 1 month after pars plana vitrectomy. Microbiological studies including cultures and antibiotic sensitivity were performed. Culture of the scleral abscess showed growth of MRSA resistant to fourth-generation fluoroquinolones and sensitive to vancomycin and erythromycin. Treatment with a combination of topical vancomycin and systemic erythromycin for 6 weeks resolved the infectious scleritis.

Conclusions: MRSA can be a cause of infectious scleritis after ocular surgery without a clear source despite surgical prophylaxis with topical fourth-generation fluoroquinolones.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Drug Therapy, Combination
  • Erythromycin / therapeutic use
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / etiology*
  • Eye Infections, Bacterial / pathology
  • Fluoroquinolones / adverse effects*
  • Follow-Up Studies
  • Humans
  • Male
  • Methicillin Resistance*
  • Scleritis / drug therapy
  • Scleritis / etiology*
  • Scleritis / pathology
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / etiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification*
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / pathology
  • Vancomycin / therapeutic use
  • Vitrectomy / adverse effects*


  • Anti-Inflammatory Agents
  • Fluoroquinolones
  • Erythromycin
  • Vancomycin