{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:40:20Z","timestamp":1756359620094,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,4]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Infectious scleritis is a rare but important cause of scleral inflammation. It is usually associated with an underlying ocular (prior ocular surgery or trauma) or systemic risk factor. A 53-year-old apparently systemically healthy woman presenting with spontaneous-onset pain, redness and watering in the left eye for 10 days was diagnosed with culture-proven <jats:italic>Pseudomonas aeruginosa<\/jats:italic> anterior scleritis. However, she was non-responsive to organism-sensitive antibiotics and scleral graft was performed twice, which showed graft re-infection. On repeated extensive systemic evaluations, the patient was diagnosed with biopsy-proven granulomatosis with polyangiitis (GPA). The patient was started on mycophenolate mofetil for both induction and maintenance phases and showed dramatic improvement with no recurrence till 1\u2009year follow-up. High index of suspicion for autoimmune disorders, especially GPA, must be maintained for unilateral relentless infective scleritis masquerading as autoimmune necrotising scleritis. Mycophenolate mofetil holds a promising role for inducing as well as maintaining disease remission in ocular GPA.<\/jats:p>","DOI":"10.1136\/bcr-2020-239517","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T12:11:19Z","timestamp":1611144679000},"page":"e239517","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Recalcitrant infective scleritis masquerading an autoimmune necrotising scleritis: a primary presentation of biopsy-proven granulomatosis with polyangiitis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4576-4915","authenticated-orcid":false,"given":"Rinky","family":"Agarwal","sequence":"first","affiliation":[{"name":"Ophthalmology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manasi","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Ophthalmology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seema","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Ocular Pathology, Dr RP Centre, All India Institute of Ophthalmic Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Sharma","sequence":"additional","affiliation":[{"name":"Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,20]]},"reference":[{"key":"2025082721594968000_14.1.e239517.1","doi-asserted-by":"crossref","DOI":"10.4103\/0301-4738.121085","article-title":"Infectious scleritis: clinical spectrum and management outcomes in India","volume":"61","author":"Pradhan","year":"2013","journal-title":"Indian J Ophthalmol"},{"key":"2025082721594968000_14.1.e239517.2","first-page":"2113","article-title":"Clinical characteristics and visual outcomes in infectious scleritis: a review","volume":"7","author":"Ramenaden","year":"2013","journal-title":"Clin Ophthalmol"},{"key":"2025082721594968000_14.1.e239517.3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(77)90125-5"},{"key":"2025082721594968000_14.1.e239517.4","article-title":"Ocular manifestations of Wegener's granulomatosis. Analysis of nine cases","volume":"51","author":"Biswas","year":"2003","journal-title":"Indian J Ophthalmol"},{"key":"2025082721594968000_14.1.e239517.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2005.12.003"},{"key":"2025082721594968000_14.1.e239517.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(83)34574-7"},{"key":"2025082721594968000_14.1.e239517.7","first-page":"279","article-title":"Current and future prospects in the management of granulomatosis with polyangiitis (Wegener's granulomatosis)","volume":"10","author":"Tarzi","year":"2014","journal-title":"Ther Clin Risk Manag"},{"key":"2025082721594968000_14.1.e239517.8","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1681\/ASN.V1091965","article-title":"Mycophenolate mofetil for maintenance therapy of Wegener's granulomatosis and microscopic polyangiitis: a pilot study in 11 patients with renal involvement","volume":"10","author":"Nowack","year":"1999","journal-title":"J Am Soc Nephrol"},{"key":"2025082721594968000_14.1.e239517.9","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s00417-015-3200-2","article-title":"Systemic immunosuppression with mycophenolate mofetil to prevent corneal graft rejection after high-risk penetrating keratoplasty: a 2-year follow-up study","volume":"254","author":"Szaflik","year":"2016","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"2025082721594968000_14.1.e239517.10","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.lpm.2013.02.067","article-title":"[A randomised trial of mycophenolate mofetil versus cyclophosphamide for remission induction of ANCA associated vasculitis]","volume":"42","author":"Jones","year":"2013","journal-title":"Presse Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239517","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T04:59:58Z","timestamp":1756357198000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,20]]},"published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1136\/bcr-2020-239517"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239517","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}