Intestinal perforations in a premature infant caused by Bacillus cereus.
Although Bacillus cereus is a ubiquitous bacterium, the incidence of neonatal infections is very low with only a few cases of B. cereus infections in neonates reported in the literature. We report the case of a premature infant with multiple intestinal perforations and an abdominal B. cereus infection. The initial course was characterized by severe cardiovascular shock, anemia, thrombocytopenia and disseminated intravascular coagulation, leading to periventricular leukomalacia, alopecia capitis and toxic epidermal necrolysis. The possible role of B. cereus-associated enterotoxins for the clinical manifestations are discussed. Our case confirms previous reports of severe clinical symptoms in B. cereus infection in premature neonates. We speculate that the systemic complications of B. cereus infection are at least partly related to the effect of B. cereus-associated enterotoxins.
Girisch
M
M
University Hospital for Children and Adolescents, Hoppe- Seyler- Str. 3, D-72076 Tuebingen, Germany. monika.girisch@med.uni-tuebingen.de
Ries
M
M
Zenker
M
M
Carbon
R
R
Rauch
R
R
Hofbeck
M
M
D000015:Abnormalities, Multiple / Q000175:diagnosis*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016863:Bacillaceae Infections / Q000175:diagnosis* / Q000628:therapy; D001409:Bacillus cereus / Q000302:isolation & purification*; D016470:Bacteremia / Q000175:diagnosis* / Q000628:therapy; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures / Q000379:methods; D004768:Enterotoxins / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004768:Enterotoxins