Daniela A Bustos-Mejia1, Rafael Parra-Medina2, Alejandra de-la-Torre3. 1. Clínica Universitaria Colombia, Fundación Universistaria Sánitas , Bogotá, Colombia. 2. Research Institute, Department of Pathology, Fundación Universitaria de Ciencias de la Salud , Bogotá, Colombia. 3. Neuroscience Research Group-NeURos, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá, Colombia.
Abstract
PURPOSE: To report a case of necrotizing scleritis associated with Epstein-Barr virus (EBV) infection. CASE REPORT: A 68-year-old woman with a history of scleral ulcer, perforation, and scleral graft, with initial negative studies for infectious processes and autoimmune systemic-diseases consulted our service for a second opinion after 2 years of treatment without improvement. She presented severe conjunctival and scleral hyperemia, vascular tortuosity in 360°, areas of scleral thinning and an elevated lesion of nodular appearance. EBV serologic antibody IgG titers were strongly positive and IgM titers were borderline. A scleral biopsy showed granulation tissue with severe inflammation without the presence of tumor cells; PCR was positive for EBV. The patient was treated with antiviral therapy with resolution of the scleritis. CONCLUSIONS: EBV although rare, should be considered as a differential diagnosis in patients with necrotizing scleritis with no improvement to conventional therapy.
PURPOSE: To report a case of necrotizing scleritis associated with Epstein-Barr virus (EBV) infection. CASE REPORT: A 68-year-old woman with a history of scleral ulcer, perforation, and scleral graft, with initial negative studies for infectious processes and autoimmune systemic-diseases consulted our service for a second opinion after 2 years of treatment without improvement. She presented severe conjunctival and scleral hyperemia, vascular tortuosity in 360°, areas of scleral thinning and an elevated lesion of nodular appearance. EBV serologic antibody IgG titers were strongly positive and IgM titers were borderline. A scleral biopsy showed granulation tissue with severe inflammation without the presence of tumor cells; PCR was positive for EBV. The patient was treated with antiviral therapy with resolution of the scleritis. CONCLUSIONS:EBV although rare, should be considered as a differential diagnosis in patients with necrotizing scleritis with no improvement to conventional therapy.