Abstract
Infectious scleritis, while being less common than immune-mediated scleritis, is an equally challenging entity. The diagnosis is often delayed due to the close similarity of clinical presentation between noninfectious and infectious etiology and also because the clinical signs of infection may be obvious only in the late stages. In addition, difficulty in isolating the microorganism and poor penetration of drugs in the avascular sclera lead to delay in response to therapy. We describe two cases of infectious scleritis: the first case had an antecedent history of trauma and was diagnosed as infectious scleritis; however, repeated scleral biopsies and microbiology workup were necessary to establish a diagnosis of fungal scleritis. The second case initially presented as nodular scleritis and was managed as immune-mediated scleritis; later the lesion demonstrated Nocardia scleritis after microbiological investigations.
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Altman AJ, Cohen EJ, Berger ST, Modino BJ. Scleritis and streptococcus pneumonia. Cornea. 1991;10(4):341–5.
Bhat PV, Jakobiec FA, Kurbanyan K, Zhao T, Foster CS. Chronic herpes simplex scleritis: characterization of 9 cases of an under recognized clinical entity. Am J Ophthalmol. 2009;148:779–89.
Brooks GJ, Mills RAD, Coster DJ. Nocardial scleritis. Am J Ophthalmol. 1992;114:371–2.
Doshi RR, Harocopos GJ, Schwab IR, Cunningham Jr E. The spectrum of postoperativescleral necrosis. Surv Ophthalmol. 2013;58:620–33.
Farell PLR, Smith RE. Bacterial corneoscleritis complicating pterygium excision. Am J Ophthalmol. 1989;107:515–7.
Foster CS, Maza MS, editors. The sclera. 1st ed. New York: Springer; 1994.
Ho Y-F, Yeh L-K, Tan H-Y, Chen H-C, Chen Y-F, Lin H-C, Chen S-Y, Hui-Kang DM, Hsiao C-H. Infectious scleritis in Taiwan – a 10-year review in a tertiary-care hospital. Cornea. 2014;33:838–43.
Iovieno A, Gore DM, Carnt N, Dart JK. Acanthamoeba sclerokeratitis: epidemiology, clinical features, and treatment outcomes. Ophthalmology. 2014;121:2340–7.
Jain V, Garg P, Sharma S. Microbial scleritis: experience from a developing country. Eye (Lond). 2009;23:255–61.
Livir-Rallatos C, El-Shabrawi Y, Zatirakis P, Pellett PE, Stamey FR, Foster CS. Recurrent nodular scleritis associated with varicella zoster virus. Am J Ophthalmol. 1998;126:594–7.
Moorthy RS, Valluri S, Rao NA. Nontuberculous mycobacterial ocular infection. Surv Ophthalmol. 2012;57:202–35.
Ramenaden ER, Raiji VR. Clinical characteristics and visual outcomes in infectious scleritis: a review. Clin Ophthalmol. 2013;7:2113–22.
Reddy JC, Murthy SI, Reddy AK, Garg P. Risk factors and clinical outcomes of bacterial and fungal scleritis at a tertiary eye care hospital. Middle East Afr J Ophthalmol. 2015;22(2):203–11.
Sainz de la Maza M, Molina N, Gonzalez-Gonzalez LA, Doctor PP, Tauber J, Foster CS. Clinical characteristics of a large cohort of patients with scleritis and episcleritis. Ophthalmology. 2012;119:43–50.
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Murthy, S.I., Sabhapandit, S. (2016). Infectious Scleritis. In: Gupta, V., Nguyen, Q., LeHoang, P., Herbort Jr., C. (eds) The Uveitis Atlas. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2506-5_111-1
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DOI: https://doi.org/10.1007/978-81-322-2506-5_111-1
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Publisher Name: Springer, New Delhi
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