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Bacillus cereus cellulitis from contaminated heroin.

S J Dancer, D McNAIR, P Finn1

  • 1Departments of Microbiology and Surgery*, Vale of Leven Hospital, Alexandria, Dunbartonshire, G83 OUA and †Biotechnology Centre of Oslo and Institute of Pharmacy, University of Oslo, 1125 Blindern, 0316 Oslo, Norway.

Journal of Medical Microbiology
|March 2, 2002
PubMed
Summary

Intravenous drug users face risks from Bacillus cereus sepsis. This study confirms a direct microbiological link between contaminated heroin and severe infections in a patient, highlighting the bacterium

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Toxicology

Background:

  • Unexplained deaths among intravenous drug users raise public health concerns.
  • Bacillus cereus is an opportunistic pathogen with increasing relevance in healthcare-associated infections.

Observation:

  • A patient presented with crepitant cellulitis and severe forearm pain, indicative of a serious soft tissue infection.
  • Ultrasonography revealed gas within the affected tissues, necessitating urgent surgical intervention.

Findings:

  • Aspirate cultures identified Bacillus cereus, which was microbiologically indistinguishable from an isolate cultured from the patient's heroin sample.
  • Advanced molecular typing techniques, including genotyping, confirmed the clonal relationship between the clinical and heroin-associated strains.

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Implications:

  • This case provides conclusive microbiological evidence linking Bacillus cereus-contaminated heroin to severe sepsis in an intravenous drug user.
  • Highlights the potential virulence of B. cereus and the need for vigilance regarding drug purity and infection control in this population.