University of Wisconsin–Madison Medical College of Wisconsin

Bacillus cereus: Beyond Gastroenteritis

Lindsey Koop, MD; Rohini Garg, MBBS; Toan Nguyen, MD; Nagarjuna Reddy Gujjula, MBBS; Manasa Velagapudi, MBBS

WMJ. 2021;120(2):145-147.

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Introduction: Bacillus cereus (B cereus) has been found within the gastrointestinal flora. Due to its ubiquity, B cereus is usually considered a contaminant. However, it can cause serious infections in certain populations.

Case Presentation: A 39-year-old woman with refractory gastroparesis requiring gastric pacemaker with a jejunostomy tube and cervical cancer status post chemotherapy presented with fever and fatigue. Initial and repeat blood cultures (from peripheral and port-a-cath access) grew B cereus and the port-a-cath was removed. She was treated with appropriate antibiotics and bacteremia resolved.

Discussion: B cereus is often associated with toxin-mediated emetic or diarrheal gastroenteritis. However, in patients with prosthetic devices or intravenous (IV) drug users, B cereus can cause serious infection. Biofilms produced by B cereus attach to indwelling catheters, allowing persistent infection until catheter removal.

Conclusion: In patients with prosthetic devices or IV drug use, B cereus should be treated with appropriated antibiotics and any indwelling catheters should be removed.

Author Affiliations: Creighton University School of Medicine, Omaha, Nebraska (Koop); CHI Health Mercy Hospital, Council Bluffs, Iowa (Garg); Department of Internal Medicine, Weill Cornell Medicine, New York, NY (Nguyen); Creighton University Medical Center, Omaha, Nebraska (Gujjula); Division of Infectious Diseases, Creighton University Medical Center, Omaha, Nebraska (Velagapudi).
Corresponding Author: Manasa Velagapudi, MBBS, Division of Infectious Diseases, Creighton University Medical Center, 7710 Mercy Road, Suite #3000, Omaha, NE 68124; phone 347.334.2714; email; ORCID ID 0000-0002-4045-3261.
Funding/Support: None declared.
Financial Disclosures: None declared.
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