Late-onset intrascleral dissemination of Stenotrophomonas maltophilia scleritis after pterygium excision.

PURPOSE: To report a case of pterygium excision-related infectious scleritis with late-onset intrascleral dissemination. METHODS: Case report. RESULTS: A 72-year-old female patient was referred for Stenotrophomonas maltophilia scleritis after undergoing pterygium excision 18 years earlier. Surgical debridement and a tectonic corneal patch graft, along with conjunctival flap, were performed to repair the scleral defect after treatment with fortified topical and systemic antibiotics. However, intrascleral dissemination of scleritis occurred 5 months after the initial episode. CONCLUSIONS: Intrascleral dissemination of S. maltophilia scleritis after pterygium excision might be delayed because of limited invasiveness and inherent resistance to several antibiotics. Long-term follow-up may be needed to protect against the possibility of late-onset intrascleral dissemination.