Answer: As you are concerned about a microbial infection, you decide to obtain bacterial staining and culture and testing for sexually transmitted diseases. At this time, the patient is afebrile with no signs of nuchal rigidity or systemic symptoms and thus blood culture, lumbar puncture, and urinalysis/ urine culture to look for urosepsis are not warranted. MRI of orbits is not warranted as symptoms appear to be localized to the front of the eye. Patient has no upper respiratory symptoms so throat swab and culture are not warranted at this time.
Lab results: Conjunctival scrapings for Gram stain and Giemsa stain reveals intracytoplasmic inclusion bodies. Cultures and PCR were positive for Chlamydia trachomatis. (Above Image Credit: © 2020 American Academy of Ophthalmology)
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Peds Ophtho Case 5 Index
Peds Ophtho Case 5: Introduction
Peds Ophtho Case 5: Additional History & Physical Exam
Peds Ophtho Case 5: Ophtho Visit