Blepharoconjunctivitis mimicking conjunctival tumor associated with Streptococcus intermedius sinusitis: case report and literature review

Streptococcus intermedius, a commensal bacterium in the human oral cavity, can occasionally cause severe infections in deep tissues. The patient was referred because of a conjunctival tumor. She had severe nasal cavity and periocular tissue inflammation that persisted for over a year. Microbiological examination of the nasal and ocular specimens identified S. intermedius as the pathogenic strain. The inflammation and the conjunctival mass subsided after systemic and topical administration of a susceptible antibiotic. Smear microscopy of the eye and nasal discharge was useful for the differential diagnosis. 16S metagenomic analysis using MinION as an adjunctive diagnostic tool has contributed to the species identification of the pathogenic strain.