Bacillus cereus pneumonia in an immunocompetent patient: a case report

Abstract

Background Bacillus cereus (B. cereus) rarely causes lower respiratory tract infections, although most reported cases of B. cereus pneumonia are fatal despite intensive antibiotic therapy. We present a case of B. cereus pneumonia in an immunocompetent patient.Case presentationAn 81-year-old woman was transferred from a district general hospital to our hospital for treatment of congestive heart failure. The patient presented with a nonproductive cough, dyspnea, edema in both lower extremities, orthopnea, fever, and occult blood in the stool. A chest radiograph indicated bilateral pleural effusion and pulmonary congestion. After diuretic therapy and chest drainage, bilateral pleural effusion and pulmonary congestion improved. On day 2, she experienced severe respiratory distress. B. cereus was isolated from two blood sample cultures. On day 4, her condition had progressed to severe respiratory distress (PaO2/FiO2 ratio = 108). A chest radiograph and computed tomography indicated extensive bilateral infiltrates. She was transferred to the intensive care unit and was intubated. B. cereus was also isolated from five blood sample cultures at that time. After isolating B. cereus, we switched antibiotics to a combination of imipenem and levofloxacin, which were effective. She had no history of immunodeficiency, surgery, ill close contacts, risk factors for HIV or tuberculosis, recent central venous catheter insertion, or anthrax vaccination. She improved and was discharged from the intensive care unit after several days.ConclusionThis is a rare case of B. cereus pneumonia in an immunocompetent patient, who subsequently recovered. Bacillus should be considered as a potential pathogen when immunocompetent patients develop severe pneumonia.

Bacteria isolated from the lower respiratory tract of sheep and their relationship to clinical signs of sheep respiratory disease

“…As mentioned in literature, many infectious agents were previously considered not be pathogenic and became be accepted as pathogenic (Farrar Jr. 1963) as happened with Bacillus sp. considered a non-contaminant in clinical samples (Shimoyama et al 2017). Otherwise Bacillus cereus is known to be responsible for nosocomial pneumonia in human, and in immunocompromised or immunocompetent human patients (Gray et al 1999, Miyata et al 2013, Shimoyama et al 2017).…”

Identification of spore-forming bacteria isolated from contaminated Lowenstein Jensen media and effectiveness of Vancomycin to reduce Mycobacterial culture contamination in Burkina-Faso

“…Indeed, Bacillus cereus is well known as a cause of food poisoning, and B. licheniformis has occasionally been isolated from cases of food associated illness 29,30 . In addition to food poisoning, B. cereus and B. licheniformis in recent years have been increasingly implicated in a wide range of infections including abscesses, bacteremia/septicemia, wound and burn infections, ear infections, endocarditis, meningitis, ophthalmitis, osteomyelitis, peritonitis, and respiratory and urinary tract infection s in both immunologically compromised and immunocompetent individuals 28,30–34 . Moreover, paenibacillus and brevisbacillus identified also in our study were sporadically isolated in clinical sample (Blood, urine, drainage, bronchial aspirate.…”

A Case of Fulminant Bacillus cereus Lung Necrosis in a Preterm Neonate

“…1,3,5,6 Necrotizing pneumonias have been reported anecdotally, including in a patient on steroids for a nephrotic syndrome from which B. cereus was recovered in bronchoalveolar lavage (BAL) and transbronchial biopsy specimens, 7 in a woman with acute lymphoblastic leukemia who presented with a dense consolidation and grew B. cereus from a BAL and multiple blood culture bottles, 8 as well as in an elderly woman with extensive infiltrates and relapsing B. cereus bacteremia. 9 Jevon et al published 2 cases of fatal necrotizing pneumonia in premature neonates, for which the surfactant was suspected to be the source of nosocomial transmission. 10 The autopsy showed extensive patchy airway and lung tissue necrosis, numerous Gram-positive bacilli, but interestingly, very few inflammatory cell infiltrates.…”