How Serious Are Bacillus Cereus Ocular Infections? -a Detrimental Effect of Undermining a Fulminant Disease: Case Report

Abstract Introduction Bacillus cereus is a gram-positive endospore-forming organism. Although not commonly encountered, it can cause a consequential ocular infection leading to severe vision loss. It is usually acquired following ocular trauma. The early suspicion and detection of this organism is often overlooked in favour of more common organisms responsible for exogenous endophthalmitis such as streptococcus or klebsiella species. We aim to shed light on Bacillus Cereus endophthalmitis and the choice of suitable antibiotics that may have led to a less severe outcome. Case Presentation We would like to report a case of how a local farmer developed fulminant endophthalmitis following ocular trauma while ploughing his garden. Initial infection was thought to be due to commonly encountered organisms in exogenous endophthalmitis. Treatment with the standard intravenous and intravitreal antibiotics was commenced but the eye still succumbed to evisceration. The delay in diagnosis and treatment caused detrimental effect to the patient’s vision. We reviewed all other cases of Bacillus cereus-related ocular infections reported previously in the literature and analyzed their outcomes. Conclusion A high index of suspicion of the accountable organisms following the mechanism of injury to the eye along with timely and appropriate choice of antibiotics can lead to a better visual outcome.