Periorbital Cellulitis Caused by Bacillus Thuringiensis

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Abstract
Purpose: Periorbital cellulitis is an inflammation of the lids and periorbital tissues without signs of true involvement such as proptosis or limitation of eye movement. Methods: Bacillus thuringiensis is a Gram-positive, spore-forming soil bacterium with the ability to produce insecticidal crystal proteins. B thuringiensis is an extremely rare causative organism of orbital and periorbital infections. However, it was rarely seen isolated in pediatric cases with preseptal cellulites. Ocular infections of this bacteria quickly progress, within 12–48 hours from inoculation, leading to endophthalmitis or panophthalmitis and irreversible vision loss. Results: Periorbital cellulitis should be recognized promptly and treated carefully. Hospitalization, prompt systemic antibiotic therapy, and careful monitoring for signs of sepsis and local invasion are critical. Conclusions: We report a rare presentation of periorbital cellulitis caused by B thuringiensis.