Pseudomonas aeruginosa scleritis initially presenting as idiopathic diffuse anterior scleritis

Pseudomonas aeruginosa remains the most common cause of bacterial scleritis. This report illustrates an unusual presentation of P. aeruginosa scleritis, which initially presented as diffuse anterior scleritis with anterior uveitis. The detailed laboratory work-up of the patient was negative, and the initiation of high-dose oral corticosteroid therapy led to further deterioration of clinical condition, with the appearance of a yellowish-white nodule within 3 days. The aspirate from the nodule grew P. aeruginosa, and the scleral inflammation resolved with anti-microbial therapy.