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

Objective: 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.