Presentation
A previously healthy 8-year-old male presented to the emergency center with right eye swelling, erythema and pain. The parents noted that the patient had tooth pain that resolved a few days before the eyelid swelling was first noticed. In the emergency center, the patient was urgently taken to the operating room for incision and drainage after imaging revealed orbital cellulitis with multiple fluid collections and optic nerve traction.
Purulent fluid was collected and sent to the microbiology lab for stains and culture. The direct Gram stain showed no organisms, and after 24 hours, no growth was observed on aerobic bacteriology plates. After 48 hours of incubation, gray/transparent colonies grew on 5% sheep blood and chocolate agar plates, while the MacConkey plate showed no growth. Notably, some colonies exhibited a central depression, and the agar plate had a bleach odor.
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Author Information
Heather Colvin Binns, Ph.D., Clinical Microbiology and Public Health Fellow, Baylor College of Medicine/Texas Children’s Hospital
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