Cryptococcal scleritis mimicking scleromalacia perforans.
Lavanya Gandepalli, Adithya R Nath, Manu Muraleekrishna et al.
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Case in brief
An elderly man with diabetes presented with progressive scleral thinning and minimal pain, initially diagnosed as scleromalacia perforans. However, surgical intervention and histopathological examination revealed primary cryptococcal scleritis. Following the diagnosis, antifungal therapy was initiated, resulting in visual improvement and clinical recovery.
What made this case unusual
The case illustrates primary cryptococcal scleritis, which is a rare infectious cause that can mimic the non-inflammatory presentation of scleromalacia perforans.
Diagnostic / clinical pearl
Clinicians should consider infectious etiologies, such as cryptococcal scleritis, in cases of atypical or non-resolving scleritis, especially when initial diagnoses suggest autoimmune conditions.
Why it matters
This case underscores the critical role of tissue biopsy in differentiating between infectious and non-infectious causes of scleritis.