BACKGROUND: The fungus Scedosporium prolificans was first described as a human pathogen in 1984, and has been associated with metastatic endophthalmitis and one previously reported case of sclerokeratitis.METHODS: We report a case of S. prolificans sclerokeratitis in the setting of late scleral necrosis complicating pterygium surgery with adjunctive beta-irradiation.RESULTS: A poor clinical response to topical natamycin and amphotericin B, and systemic itraconazole and ketoconazole was encountered. Enucleation was required, with subsequent microbiological cure. Pathological correlation is described.CONCLUSIONS: S. prolificans infections often respond poorly to medical therapy. Early surgical intervention is indicated in culture-proven scleritis due to Scedosporium prolificans.
Aged Anti-Bacterial Agents