A 17-year-old male patient presents to the clinic with complaints of pain and swelling of the left eye for two days. He also reports fever, pain with eye movement, and double vision. He denies any trauma, insect bite, headache, numbness or tingling sensation in any parts of the body. He had mild toothache one week back. On examination, the temperature is 101 F (38.3 C), and the pulse is 84 beats/min. On examination of the left eye shows erythema and edema of the eyelid. CBC with differential shows leukocytosis. CT scan reveals inflammation of extraocular muscles and fat stranding without intracranial extension. What is the causative agent?
1. ANAEROBIC ORGANISMS
2. AEROBIC NON-SPORE-FORMING ORGANISMS
3. ANAEROBIC SPORE-FORMING ORGANISMS
4. FACULTATIVE ANAEROBES
*Option 2 *
This patient presents with fever, pain, and swelling of the eye along with a history of dental infection, and the CT scan finding of inflammation of extraocular muscles and fat stranding suggests a most likely diagnosis of orbital cellulitis. Common organisms in orbital cellulitis are aerobic and non-spore-forming.
Staphylococcus aureus, Streptococcus, Haemophilus spp, and non-spore-forming anaerobes are the most commonly identified organisms in culture-positive orbital cellulitis.
However, many other common and rare bacterial pathogens have been documented in individual cases and case series.
One unusual bacterial cause of orbital cellulitis is Eikenella corrodens, an organism that is difficult to isolate.