Poststreptococcal syndrome mimicking conjunctival lymphoma

Optical Coherence Tomography Findings in Nodular Anterior Scleritis due to Post-Streptococcal Syndrome

Purpose

To report a case of nodular anterior scleritis due to poststreptococcal syndrome using optical coherence tomography imaging.

Case Report

A 41-year-old woman with a history of acute rheumatic fever presented with a nodular anterior scleritis. Common causes were excluded. Optical coherence tomography of sclera showed enlarged vessels, inflammatory infiltrates, separated fibers, and a serous detachment. Laboratory investigations showed an elevated erythrocyte sedimentation rate, raised anti-streptolysin O titer, and the presence of group A streptococcus in the throat. The scleritis rapidly improved with penicillin treatment.

Conclusion

Poststreptococcal syndrome should be considered in the etiology of non-necrotizing anterior scleritis.

Case report: a diagnostically challenging conjunctival mass caused by the Epstein-Barr virus

We present a paediatric case of infectious mononucleosis in a 13-year old, manifesting with follicular conjunctivitis and a conjunctival mass in one eye with no evidence of leucocytosis on the blood count. The diagnosis was confirmed following surgical excision and biopsy. The case represented a diagnostic challenge due to its atypism and given the steady increase in the prevalence of EBV-related ocular diseases in the last years, this report can serve as an example to prompt earlier serological tests to identify the aetiology in similar cases. This is important because EBV can be treated with acyclovir early in the active viral phase.