DR. KRISHNA ANUSHA CHINNI
DR.ANIL RADHAKRISHNAN, DR. SUJITHRA HARIDAS, DR.MANOJ PRATHAPAN
Abstract
A middle aged male with a history of left eye wound exploration and suturing following injury with a wooden piece on high dose systemic and topical steroids presented to us with intractable pain and redness.o/e mutiple necrotic scleral nodules were seen.Extensive systemic work up revealed leucocytosis with high ESR and CRP while the rest being unremarkable.Thereby, a diagnosis of infective scleritis was made and was started on parentral and topical antibiotics, with rapid taper of steorids.Necrotic debridement was done and materials sent for microbiological and histopathological study showed exophiala jeanselemi.Despite aggressive antimicrobial therapy and debridement there was poor response with appearance of fresh nodules, corneal involvement and choroidal detachment necessitating enucleation. hence Infective scleritis can easily mimick necrotising scleritis and mislead treatment,eradication of such an unusual fungus quite often is not possible if pretreated with steroids.


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