Bacillus cereus: Beyond Gastroenteritis

Abstract

Introduction: Bacillus cereus (B cereus) has been found within the gastrointestinal flora. Due to its ubiquity, B cereus is usually considered a contaminant. However, it can cause serious infections in certain populations.

Case presentation: A 39-year-old woman with refractory gastroparesis requiring gastric pacemaker with a jejunostomy tube and cervical cancer status post chemotherapy presented with fever and fatigue. Initial and repeat blood cultures (from peripheral and port-a-cath access) grew B cereus and the port-a-cath was removed. She was treated with appropriate antibiotics and bacteremia resolved.

Discussion: B cereus is often associated with toxin-mediated emetic or diarrheal gastroenteritis. However, in patients with prosthetic devices or intravenous (IV) drug users, B cereus can cause serious infection. Biofilms produced by B cereus attach to indwelling catheters, allowing persistent infection until catheter removal.

Conclusion: In patients with prosthetic devices or IV drug use, B cereus should be treated with appropriated antibiotics and any indwelling catheters should be removed.