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[Meningitis due to Bacillus cereus in an infant with Reye syndrome]
A Ferroni1, M H Odièvre, E Abachin
1Laboratoire de microbiologie, hôpital Necker-Enfants-malades, Paris, France.
Observation:
We report the case of a 2.5-month-old infant with Bacillus cereus meningitis who was initially admitted for Reye syndrome. Gram positive bacteria was isolated in CSF and shown to be located inside the polymorphonuclears. This pathogen was further identified by sequencing of the 16S RNA. Early administration of imipenem in association with amikacin resulted in a rapid recovery. No obvious immune defect or invasive procedure could be assessed.
Conclusion:
Although Bacillus cereus is mainly associated with contamination, repeated isolations of this bacteria may be due to true infection.
Insights
Bacillus cereus meningitis in an infant, initially suspected as Reye syndrome, was successfully treated with antibiotics. This case highlights that repeated Bacillus cereus findings can indicate true infection, not just contamination.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Neonatal Care
Background:
- Reye syndrome is a rare but serious condition affecting children and teenagers.
- Bacillus cereus is a Gram-positive bacterium commonly associated with food poisoning and opportunistic infections.
Observation:
- A 2.5-month-old infant presented with symptoms initially suggestive of Reye syndrome.
- Cerebrospinal fluid (CSF) analysis revealed Gram-positive bacteria within polymorphonuclear leukocytes.
- The pathogen was identified as Bacillus cereus through 16S ribosomal RNA sequencing.
Findings:
- Early treatment with imipenem and amikacin led to a rapid clinical recovery in the infant.
- No underlying immune deficiency or history of invasive procedures was identified in the patient.
Implications:
- This case underscores the importance of considering Bacillus cereus as a potential pathogen in infant meningitis, even when initially presenting with symptoms mimicking other conditions.
- Repeated isolation of Bacillus cereus should prompt investigation for true infection rather than assuming contamination.
- Prompt and appropriate antibiotic therapy is crucial for favorable outcomes in neonatal Bacillus cereus meningitis.