Inverse hypopyon as the presenting feature of infectious scleritis in a case of tropical pyomyositis

Abstract

<h2>Abstract</h2> <b>Case report:</b> A 25-year-old man presented with inverse hypopyon due to dense inflammatory exudation in the left eye. He was an ascetic with a history of long pilgrimages barefoot. Drainage of the pyogenic material with superficial exploration revealed localized scleral thinning at 2′o clock. Two days later, a thigh abscess was noted, which on ultrasonography showed hypoechoic areas with increased muscle mass suggestive of tropical pyomyositis. The culture from anterior chamber aspirate grew <i>Staphylococcus aureus</i>, as did 200 mL of pus drained from the thigh. His ocular condition improved significantly with high-dose systemic antibiotics. <b>Comments:</b> To our knowledge, this unusual presentation of infectious scleritis and coexistent pyomyositis has not been previously reported in the literature.