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Bacillus cereus bacteremia and meningitis in immunocompromised children

A H Gaur1, C C Patrick, J A McCullers

  • 1Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 24, 2001
PubMed

Insights

Bacillus cereus meningitis can be severe in immunocompromised children, especially those with neutropenia or recent intrathecal chemotherapy. Early diagnosis and targeted therapies are crucial for better outcomes in invasive Bacillus cereus infections.

Area of Science:

  • Infectious Diseases
  • Pediatric Medicine
  • Microbiology

Background:

  • Invasive Bacillus cereus infections are rare but serious, particularly in immunocompromised pediatric patients.
  • Two cases of Bacillus cereus meningitis in children prompted a review of invasive B. cereus disease.

Purpose of the Study:

  • To review and characterize invasive Bacillus cereus disease in pediatric patients.
  • To identify risk factors and outcomes associated with B. cereus infections, including central nervous system (CNS) involvement.

Main Methods:

  • Retrospective review of 12 pediatric patients with B. cereus isolated from blood cultures between September 1988 and August 2000.
  • Patients were categorized into Group A (CNS involvement) and Group B (no CNS involvement).
  • Clinical data, including neutropenia, intrathecal chemotherapy, and outcomes, were analyzed.

Main Results:

  • 33% of patients (Group A) had CNS involvement (meningitis or possible CNS disease), while 67% (Group B) did not.
  • Group A patients were more likely to have neutropenia and unfavorable outcomes, including death or severe sequelae.
  • Intrathecal chemotherapy in the preceding week was associated with increased risk in Group A.
  • No deaths or sequelae were observed in Group B.

Conclusions:

  • Invasive Bacillus cereus disease, particularly with CNS involvement, poses a significant risk to immunocompromised children.
  • Neutropenia and recent intrathecal chemotherapy are critical risk factors for severe outcomes.
  • Rapid diagnosis and effective therapies targeting B. cereus and its toxins are essential due to the short interval to severe damage or death.

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