Bacillus cereus pneumonia in a patient with acute lymphoblastic leukemia.
Reported here is a case of Bacillus cereus pneumonia that occurred in a patient with acute lymphoblastic leukemia. The presentation was severe, essentially marked by respiratory distress and pleuritic chest pain. Classic empirical treatment initiated for febrile neutropenia did not cover this rare pathogen and appropriate therapy was therefore delayed. B. cereus is most often a culture contaminant, but it can also be responsible for self-limited gastrointestinal intoxication and, more rarely, severe systemic diseases. Virulence in the case of systemic disease is attributed to tissue necrosis mediated by toxin release. B. cereus pneumonia, as described in the English-language literature, mainly affects immunocompromised patients and most often has a fatal outcome. Thus, the identification of B. cereus in clinical specimens of severely ill immunocompromised patients should lead physicians to question its clinical significance.
Department of Infectious Diseases, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, Anderlecht, Belgium. jfrankar@ulb.ac.be
J
J
Frankard
R
R
Li
F
F
Taccone
M J
MJ
Struelens
F
F
Jacobs
A
A
Kentos
D000328:Adult; D000900:Anti-Bacterial Agents; D016863:Bacillaceae Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D001409:Bacillus cereus / Q000302:isolation & purification*; D018450:Disease Progression; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D009102:Multiple Organ Failure / Q000175:diagnosis; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents