Bacillus cereus Causing Fulminant Sepsis and Hemolysis in Two Patients With Acute Leukemia

Abstract

Bacillus cereus infection can have a fulminant clinical course that may be complicated by massive intravascular hemolysis. This pathogen should be suspected in immunosuppressed patients who experience gastrointestinal symptoms and should not be precluded by the absence of fever, especially if steroids such as dexamethasone are being given. Exchange transfusion may be lifesaving in Bacillus cereus septicemia associated with massive hemolysis.

CwpFM (EntFM) Is a Bacillus cereus Potential Cell Wall Peptidase Implicated in Adhesion, Biofilm Formation, and Virulence

“…Rare but severe opportunistic infections have been attributed to B. cereus (4,12,34). The pleiotropic regulator PlcR controls the expression of several B. cereus secreted factors, such as the nonhemolytic enterotoxin (Nhe), the hemolysin BL (Hbl), and the cytotoxin K (CytK) (1,19).…”

InhA1, NprA, and HlyII as Candidates for Markers To Differentiate Pathogenic from NonpathogenicBacillus cereusStrains

“…The main affections observed are endophthalmitis, periodontitis, meningitis, and encephalitis (5,8,13,14,22,42). Moreover, a B. cereus strain has caused lethal infections resembling anthrax (36), and several cases of bacteremia in preterm neonates have been described, highlighting this public health problem (35,49).…”

Bacillus cereus Sepsis in the Treatment of Acute Myeloid Leukemia

“…The poor outcomes in acute leukemia patients may have been an indirect consequence because of the greater immunosuppression following intensive chemotherapy, rather than due to the underlying disease. Regarding the relationship between B. cereus sepsis and the treatment process of acute leukemia in the combined clinical parameters, 35 patients developed sepsis during remission induction or reinduction therapy, 9 consolidation therapy, 4 posttransplantation, and 1 maintenance therapy in a total of 49 acute leukemia patients whose clinical data were available (Akiyama, et al 1997, Arnaout, et al 1999, Christenson, et al 1999, Colpin, et al 1981, Cone, et al 2005, Coonrod, et al 1971, Dohmae, et al 2008, Feldman and Pearson 1974, Frankard, et al 2004, Funada, et al 1988, Garcia, et al 1984, Gaur, et al 2001, Ginsburg, et al 2003, Ihde and Armstrong 1973, Jenson, et al 1989, Katsuya, et al 2009, Kawatani, et al 2009, Kiyomizu, et al 2008, Kobayashi, et al 2005, Kuwabara, et al 2006, Le Scanff, et al 2006, Leff, et al 1977, Marley, et al 1995, Motoi, et al 1997, Musa, et al 1999, Nishikawa, et al 2009, Ozkocaman, et al 2006, Sakai, et al 2001, Strittmatter, et al 1995,…”

“…To our knowledge, 46 B. cereus sepsis patients with hematologic malignancies have been previously reported (Akiyama, et al 1997, Arnaout, et al 1999, Christenson, et al 1999 et al 1981, Cone, et al 2005, Coonrod, et al 1971, Dohmae, et al 2008, Feldman and Pearson 1974, Frankard, et al 2004, Funada, et al 1988, Garcia, et al 1984, Gaur, et al 2001, Ginsburg, et al 2003, Ihde and Armstrong 1973, Jenson, et al 1989, Katsuya, et al 2009, Kawatani, et al 2009, Kiyomizu, et al 2008, Kobayashi, et al 2005, Kuwabara, et al 2006, Le Scanff, et al 2006 www.intechopen.com al 1977, Marley, et al 1995, Motoi, et al 1997, Musa, et al 1999, Nishikawa, et al 2009, Ozkocaman, et al 2006, Sakai, et al 2001, Strittmatter, et al 1995, Tomiyama, et al 1989, Trager and Panwalker 1979, Yoshida, et al 1993. On analyses of the clinical parameters of these patients, as in shown in Table 2, patients with acute leukemia, a neutrophil count of 0/mm 3 or below the lower limit of each institute, or CNS symptoms at febrile episodes were identified as risk factors closely correlated with a fatal prognosis (P=0.044, 0.004, and 0.002, respectively).…”