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Pseudomembranous tracheobronchitis due to Bacillus cereus.

R Strauss¹, A Mueller, M Wehler

¹Department of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany. richard.strauss@med1.imed.uni-erlangen.de

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America

|August 7, 2001

Summary

A severe aplastic anemia patient developed pseudomembranous tracheobronchitis and pneumonia due to Bacillus cereus. This rare bacterial infection, potentially toxin-mediated, proved fatal despite aggressive antibiotic therapy.

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Area of Science:

Infectious Diseases
Pulmonology
Hematology

Background:

Severe aplastic anemia (SAA) is a rare but serious condition characterized by bone marrow failure.
Patients with SAA are immunocompromised, increasing their susceptibility to opportunistic infections.
Pseudomembranous tracheobronchitis is a severe airway inflammation characterized by the formation of pseudomembranes.

Observation:

A 52-year-old woman with SAA presented with rapidly progressive respiratory symptoms.
The patient developed pneumonia and pseudomembranous tracheobronchitis.
Bacillus cereus was identified in bronchoalveolar lavage fluid, blood cultures, and tracheal pseudomembranes.

Findings:

This case represents the first documented instance of Bacillus cereus causing pseudomembranous tracheobronchitis.

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The infection rapidly progressed despite broad-spectrum and targeted antibiotic treatment.

Bacterial toxins are suspected as a key factor in the pathogenesis of this severe airway disease.

Implications:

This case highlights the potential for Bacillus cereus to cause severe, life-threatening respiratory infections in immunocompromised individuals.
It underscores the importance of considering unusual pathogens and toxin-mediated mechanisms in refractory airway infections.
Further research into the virulence factors of Bacillus cereus and their role in tracheobronchial disease is warranted.