Neonatal Conjunctivitis from Bacillus Cereus

Abstract

Background: Bacillus cereus is a high virulence bacteria that can cause blindness rapidly in 1-2 days, usually from keratitis, endophthalmitis or panophthalmitis, and rarely found in neonate. We report a case of ocular Bacillus cereus infection in newborn patient in Buriram province, Thailand.
Case presentation: A 12-day-old female newborn presented with purulent neonatal conjunctivitis without corneal involvement on both eyes for 3 days. No history of red eyes, dysuria, urethral or vaginal discharge in her parents. After being treated as gonococcal conjunctivitis; systemic intravenous cefotaxime, copious eye irrigation, moxifloxacineyedrops combined with oral erythromycin syrup to treat concomitant Chlamydial infection, her clinical improved in 24 hours and was able to decrease frequency of moxifloxacineyedrops to four times a day at 48 hours. Conjunctival swab culture at 48 hours was reported as positive for moderate Bacillus cereus. Further history taking revealed that this patient was given superstitious ritual by blowing some chewed plant roots on her face for 3 days before onset of red eyes. However, after continue systemic antibiotics until 7 days and topical antibiotics until 10 days, clinical red eyes disappeared. No recurrence after discontinued antibiotics for 1 week.
Conclusion: Superstitious rituals are still common in some area of Buriram province especially among people who are Thai of Cambodian descent. Chewed plant roots that can be contaminated usually be blew on newborn’s face. Therefore, it is important to get this information in case of severe ocular infection in newborn.