Bacillus cereus from refulgent corneal ulcer: A case report

A Gram-positive spore forming bacilli, aerobe or facultative anaerobe is . It is ubiquitous which disperse in the environment. is a potential pathogen accountable for fulminant human infectious disease and hardly ever contribute to eye infections. A 35-year-old farmer came to ophthalmology OPD on February 2019, and the patient complained of acute onset left eye pain with diminution of vision. There was history of eye injury by the vegetation (thorn). There was presence of corneal ulcer. The patient was not immunocompromised.Corneal scrapping was collected from left eye. On Gram staining from corneal scrapping only two Gram positive bacilli, with occasional pus cell and fibrinous exudate was seen. Culture on blood agar medium it showed beta haemolytic, about 2-5 mm in diameter, big flat, irregular edges and greyish white colonies which were oval, slightly granular but not dry. On Mac -Conkey agar medium it showed non lactose fermenting, big flat, irregular colonies.From colonies Gram staining showed Gram positive bacilli with spore. They were motile, catalase positive, oxidase positive, reduced nitrate to nitrite and were resistant to penicillin. The identification was also confirmed by Vitek. This case highlights the importance of cultivation, detection and antibiotic susceptibility test rather than treating patients with ocular infection empirically.