Nodular Necrotizing-Scleritis Associated with Epstein-Barr Virus Infection: A Case Report

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.

Keywords:

• Epstein-Barr virus (EBV)
• Necrotizing scleritis
• PCR

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

DECLARATION OF PATIENT CONSENT

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for images and the clinical information to be reported in the journal. The patient understands that her name and initials will not be published, and due effort will be made to conceal her identity, but anonymity cannot be guaranteed.

ACKNOWLEDGMENTS

We thank the patient for granting permission to publish this information.