title: A patient with acute myeloid leukemia who developed fatal pneumonia caused by carbapenem-resistant Bacillus cereus.
abstract: Bacillus cereus is known as a serious bacterial pathogen in neutropenic patients. B. cereus is often resistant to beta-lactams, including penicillins and cephalosporins. We report a case of fatal pneumonia caused by B. cereus in a patient with newly diagnosed acute myeloid leukemia (AML) during remission induction therapy. Cefepime was started for febrile neutropenia (FN) initially and was switched to panipem/betamipron, when fulminant pneumonia supervened. The isolated strain was resistant not only to cefepime but also to panipenem/betamipron. This is the first report of fulminant infection caused by carbapenem-resistant B. cereus in a neutropenic patient. B. cereus should be kept in mind as a target of empirical treatment when neutropenic patients develop pneumonia.
authors.affiliation: The Department of Medicine, Division of Medical Oncology, Infectious Disease, and Endocrinology, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. hkatsuya829@yahoo.co.jp
authors.forename: Hiroo
authors.initials: H
authors.lastname: Katsuya
authors.forename: Tohru
authors.initials: T
authors.lastname: Takata
authors.forename: Takahiko
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Sasaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishitsuka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takamatsu
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tamura
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D016863:Bacillaceae Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D001409:Bacillus cereus / Q000187:drug effects* / Q000302:isolation & purification; D015780:Carbapenems / Q000494:pharmacology* / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009503:Neutropenia; D018410:Pneumonia, Bacterial / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D015780:Carbapenems