title: Occult Fungal Scleritis.
abstract: OBJECTIVE
  To heighten awareness of occult fungal scleritis.
  
  
  METHODS
  Case report and review of the literature.
  
  
  RESULTS
  A 73-year-old woman with diabetes mellitus was diagnosed for 3 months with immune-mediated scleritis and subsequently treated with corticosteroids. On referral, the patient had a scleral nodule with contiguous corneal infiltrate and hypopyon. Culture grewFusariumspecies not further classified. The infection could not be controlled with antifungal therapy, and the eye was removed. No exogenous or endogenous source for the infection could be identified by clinical history or examination.
  
  
  CONCLUSIONS
  Fungal scleritis can develop in persons without a history of foreign body injury, minor trauma, or evidence of endogenous fungemia. A high index of suspicion for infectious scleritis must be maintained in persons with presumed immune-mediated scleritis who fail to respond to conventional therapy, particularly if they present with decreased visual acuity.
authors.affiliation: Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA.
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Jeang
authors.affiliation: Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Davis
authors.affiliation: Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Madow
authors.affiliation: Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA; Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA.
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Espana
authors.affiliation: Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA; Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA.
authors.forename: Curtis E
authors.initials: CE
authors.lastname: Margo
keywords: Fusarium scleritis; Infectious scleritis; Subtenon triamcinolone acetonide