Central Venous Access Device-Related Bacillus Cereus Endocarditis: A Case Report and Review of the Literature

Abstract

Bacillus cereus typically presents as a gastrointestinal infection, but rarely manifests as systemic disease. This report describes a case of B. cereus-related endocarditis that presented as a sickle cell crisis and bacteremia. Initial clinical suspicion was for laboratory contamination of blood cultures. The case herein described is intended to demonstrate an uncommon presentation of B. cereus infection and highlights the value of an aggressive need to further investigate and interpret unexpected blood culture findings in clinical practice, early adequate antimicrobial therapy, prompt diagnosis, and consideration to urgent surgical interventions in such cases.

Keywords: Bacillus cereus; Bacillus species; Bacteremia; Central venous catheter infection; Infective endocarditis.

Figure 1

Standard 2-D transthoracic echocardiogram apical four chamber view with focus to the right atrium (RA) and ventricle (RV) demonstrating an ill-defined echogenic dense lesion (V) within the right atrium attached to the Medical Port central venous catheter.

Figure 2

Mid-esophageal transesophageal echocardiogram window (typically at 30–40 cm with an angle range of 0–20 degrees) demonstrating an echogenic dense lesion (V) within the right atrium (RA) attached to the atrial surface of the tricuspid valve (TV). The left atrium (LA) and right ventricle (RV) are also pictured in this view.