Posterior Nodular Scleritis in a Leukemic Patient: A Case Report

Introduction: This is an observational case report to detail a challenging case of nodular posterior scleritis (NPS) in a leukemic patient following chemotherapy and allograft. Case Presentation: A 69-year-old leukemic patient presented with unilateral vision loss and pain following febrile neutropenia caused by bacteremia and infectious pneumopathy. Ocular B-mode ultrasound and cerebral magnetic resonance imaging revealed posterior scleritis with a scleral nodule, exudative retinal detachment (ERD), and choroiditis with serous choroidal detachment (SCD). The anterior chamber tap and systemic investigations were normal. Vitrectomy with vitreous biopsy did not provide additional information. A diagnosis of idiopathic nodular posterior scleritis was made. Topical corticosteroids, intravitreal injections of vancomycin and ceftazidime, oral trimethoprim-sulfamethoxazole, and intravenous tazocillin were administered. Over the following weeks, the SCD completely regressed, while the nodule and the ERD partially regressed. Conclusion: NPS is a rare pathology, most commonly idiopathic. A systemic checkup and vitrectomy with subretinal biopsy should be considered in immunosuppressed leukemic patients when the etiology of the nodule remains uncertain.