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Published on: September 14, 2013
Bacillus cereus: the forgotten pathogen
Anand Pillai1, Stephanie Thomas, Jayant Arora
1Departments of Orthopaedics & Trauma Surgery, Glasgow, Scotland, United Kingdom.
Background:
Infection with Bacillus cereus is generally associated with gastrointestinal effects of food poisoning linked to infected rice. Isolates of B. cereus in hospital and clinical settings from any material other than vomitus or feces are commonly dismissed as contaminants.
Case Report:
We report a case of B. cereus surgical site infection after fasciotomy in a healthy 31 year-old man admitted to the orthopedic ward with a comminuted fracture of the tibia. No source was identified.
Conclusions:
This report highlights the risk of surgical site infection with an unlikely bacterium known to contaminate surgical materials. It stresses the importance of vigilance against this infrequent but potentially serious non-gastrointestinal bacillary infection, as organisms dismissed initially as contaminants may lead to rapid clinical deterioration. The use of antimicrobial agents with nosocomial coverage, even of non-nosocomial pathogens, is considered in the treatment of postoperative surgical site infections.
Insights
Bacillus cereus typically causes food poisoning but can lead to serious surgical site infections. Vigilance is crucial as dismissed contaminants may cause rapid deterioration.
Area of Science:
- Infectious Diseases
- Microbiology
- Surgical Site Infections
Background:
- Bacillus cereus is commonly linked to foodborne illness, particularly from contaminated rice.
- Clinical isolates of B. cereus from non-gastrointestinal sources are often disregarded as contaminants.
- This case highlights a rare non-gastrointestinal manifestation of B. cereus infection.
Observation:
- A case of Bacillus cereus surgical site infection (SSI) following fasciotomy is presented.
- The patient was a healthy 31-year-old male with a comminuted tibia fracture.
- No clear source of B. cereus infection was identified.
Findings:
- B. cereus can cause severe surgical site infections, challenging its typical association with gastrointestinal illness.
- Early identification and appropriate treatment are critical to prevent rapid clinical decline.
- The bacterium, often dismissed as a contaminant, poses a significant risk in surgical settings.
Implications:
- Healthcare providers must maintain vigilance for unusual pathogens in surgical site infections.
- Antimicrobial therapy should consider broad coverage, including for potential nosocomial pathogens.
- This case underscores the need to investigate seemingly contaminant organisms in postoperative infections.
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