Pseudomonas-induced scleritis mimicking autoimmune necrotizing scleritis. A case report.

To report a case of spontaneous-onset unilateral scleritis and keratitis due to Pseudomonas aeruginosa in a patient with systemic lupus erythematosus who partially responded to antibiotic therapy and achieved complete resolution after IV immunotherapy. A 30-year-old woman with a past medical history of hypothyroidism and systemic lupus erythematosus and on irregular therapy presented with a long-history of thinning of the sclera and cornea refractory to antibiotic therapy despite a positive culture for P. aeruginosa, which eventually resolved with the implementation of immunotherapy. Infectious scleritis is an uncommon and diagnostically challenging scleral inflammation. However; we must rule it out in patients with autoimmune diseases due to the inherent risk of these patients as their immune system has been impaired.