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Bacillus cereus-induced myonecrosis.
The Journal of Trauma
|March 1, 1984
Summary
A crush injury led to Bacillus cereus myonecrosis, mimicking Clostridium perfringens. Empiric treatment should include high-dose penicillin and aminoglycosides for suspected Gram-positive rod infections pending culture results.
Area of Science:
- Infectious Diseases
- Microbiology
- Trauma Surgery
Background:
- Crush injuries can lead to severe soft tissue infections.
- Myonecrosis is a serious complication often associated with Clostridium species.
- Accurate identification of causative pathogens is crucial for effective treatment.
Observation:
- A patient with an arm crush injury developed myonecrosis.
- Muscle and wound aspirates revealed Gram-positive rods.
- Initial treatment was for suspected Clostridium perfringens infection.
Findings:
- Culture results identified Bacillus cereus as the causative organism.
- Bacillus cereus demonstrated resistance to penicillin.
- This highlights a potential diagnostic and therapeutic challenge.
Implications:
- Empiric antibiotic coverage for suspected Gram-positive rod infections should be broadened.
- High-dose penicillin combined with an aminoglycoside is recommended pending culture and sensitivity results.
- This case underscores the importance of considering Bacillus cereus in myonecrosis and its antibiotic resistance patterns.