Br J Ophthalmol 1999;83:410-413 ( April )
Haemophilus influenzae associated
scleritis
Scott O Sykes,b
Christopher Riemann,c
Carmen I Santos,d
David M Meisler,c
Careen Y Lowder,c
John P Whitcher,a b
Emmett T Cunningham Jra b
a The Francis I
Proctor Foundation, b Department of Ophthalmology, UCSF, School of
Medicine, San Francisco, California, c Department of
Ophthalmology, The Cleveland Clinic Foundation, Cleveland, Ohio, d Department
of Ophthalmology, University of Puerto Rico School of Medicine, San
Juan, PR 00927
Correspondence to: Dr
Emmett T Cunningham Jr, The Pearl and Samuel J Kimura Ocular Immunology
Laboratory, The Francis I Proctor Foundation, UCSF, School of Medicine,
San Francisco, CA 94143-0944, USA.
Accepted for publication 22 October 1998
AIMS
To describe the
clinical course and treatment of Haemophilus
influenzae associated scleritis.
METHODSRetrospective
case series.
RESULTSThree
patients developed scleritis associated with ocular
H influenzae infection. Past medical history, review of systems, and laboratory testing for underlying collagen vascular disorders were
negative in two patients. One patient had arthritis associated with an
antinuclear antibody titre of 1:160 and a Westergren erythrocyte sedimentation rate of 83 mm in the first hour. Each patient had ocular
surgery more than 6 months before developing scleritis. Two had
cataract extraction and one had strabismus surgery. Nodular abscesses
associated with areas of scleral necrosis were present in each case.
Culture of these abscesses revealed H
influenzae in all patients. Treatments included topical,
subconjunctival, and systemic antibiotics. Scleral inflammation
resolved and visual acuity improved in each case.
CONCLUSIONH
influenzae infection may be associated with scleritis. Accurate
diagnosis and treatment may preserve ocular integrity and good visual acuity.
Keywords:
necrosis;
scleritis;
Haemophilus influenzae
© 1999 by British Journal of Ophthalmology
