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Bacillus cereus infection of the penis: an unusual infection
Oussama G Nasrallah1, Jana H Mahdi2, George F Araj3
1Division of Urology, Department of Surgery.
Background:
Bacillus cereus (B. cereus) is a Gram-positive, rod-shaped, motile organism, found in the environment and may exist in contaminated food sources such as reheated rice, vegetables and may lead to gastrointestinal symptoms after ingestion including diarrhea, nausea, and vomiting due to enterotoxigenic and emetic toxins. Non-gastrointestinal infections of Bacillus cereus have been reported in the literature, which include cutaneous and non-cutaneous infections in immunocompetent and immunocompromised individuals.
Case Presentation:
A 38-year-old man presented with a one-week history of penile swelling and redness that started after an episode of severe diarrhea and vomiting, which soiled his genital region few hours after vigorous intercourse with his wife. This has led to infection of the penile skin by an unusual organism: Bacillus (B.) cereus. The patient was treated using fucidic acid ointment applications for 2 weeks achieving complete recovery.
Clinical Discussion:
The recovery of B. cereus from the penile infection in our patient reveals the first case of such an unusual infection, though this pathogen has been reported to cause a wide range of non-GI tract infections, which include bacteremia, meningitis, endocarditis, endophthalmitis, pneumonia, and soft tissue diseases. Virulence factors allow this organism to induce diarrhea in addition to having dermonecrotic, cytotoxic, hemolytic properties resulting in a wide range of dermatologic presentations.
Conclusion:
The authors report a unique case of penile skin infection caused by B. cereus, an unusual culprit for an uncommon presentation successfully treated with fucidic acid ointment. This is the first case in literature describing such an entity.
Insights
This study reports the first case of a penile skin infection caused by Bacillus cereus (B. cereus), a bacterium typically associated with foodborne illness. The infection, occurring after severe diarrhea, was successfully treated with fucidic acid ointment.
Area of Science:
- Microbiology
- Infectious Diseases
- Dermatology
Background:
- Bacillus cereus (B. cereus) is a Gram-positive bacterium commonly found in the environment and associated with foodborne gastrointestinal illnesses.
- While typically causing gastrointestinal symptoms, B. cereus can also lead to various non-gastrointestinal infections, including cutaneous and systemic infections.
Observation:
- A 38-year-old male presented with penile swelling and redness following an episode of severe diarrhea and vomiting.
- The symptoms developed after genital soiling subsequent to vigorous sexual activity.
Findings:
- The penile infection was diagnosed as being caused by Bacillus cereus, an unusual pathogen for this presentation.
- The patient received a 2-week course of fucidic acid ointment, resulting in complete recovery.
Implications:
- This case represents the first documented instance of Bacillus cereus causing a penile skin infection.
- The findings highlight the diverse clinical presentations of B. cereus infections and its potential dermatologic impact due to its virulence factors.
- Successful treatment with topical fucidic acid suggests a viable therapeutic option for similar rare infections.
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