Abstract
PURPOSE: This is a case report of an unusual case of the family transmission of Streptococcus pyogenes infection in three siblings. One brother contracted the infection which resulted in orbital cellulitis of two of his siblings, in the absence of anatomical or immunological predisposing factors. OBSERVATIONS: A young boy contracted an uncomplicated S pyogenes upper respiratory tract infection. The twin brother closely followed by the older sister both developed a S pyogenes orbital cellulitis a couple of days later. CONCLUSIONS AND IMPORTANCE: To our knowledge, this is the first case ever reported of family transmission of orbital cellulitis. This highlights the importance of early diagnosis and treatment of S pyogenes, and the role of throat cultures as means of diagnosis even in the absence of symptoms or signs of pharyngitis.