Bacillus cereus bacteremia with central nervous system involvement: A neuropathological study

Area of Science:

• Microbiology
• Infectious Diseases
• Pathology

Background:

• Bacillus cereus is a common bacterium, often a contaminant, but can cause food poisoning or localized infections.
• True B. cereus bacteremia is infrequent, primarily affecting immunocompromised or fragile individuals.
• This study examines a fatal case of B. cereus bacteremia in a patient with acute myeloid leukemia.

Observation:

• A 64-year-old patient with acute myeloid leukemia developed fever during neutropenia post-chemotherapy.
• The patient progressed to B. cereus bacteremia with invasive infection and a fatal outcome.
• Histological examination revealed bacilli dissecting blood vessel walls and causing luminal occlusion, a novel finding.

Findings:

• The case study details clinical, radiological, and pathological findings.
• Comparison with 21 previous cases from the institution highlights diagnostic difficulties.
• Delayed targeted antibiotic therapy was associated with aggressive infection progression.

Implications:

• This case underscores the challenge in diagnosing B. cereus bacteremia.
• Prompt initiation of effective antibiotic treatment is crucial for managing aggressive B. cereus infections.
• The newly reported pathological pattern of vascular invasion provides insights into B. cereus virulence.