title: Rapid detoxification of cereulide in Bacillus cereus food poisoning.
abstract: Bacillus cereus is recognized as a major pathogenic bacterium that causes food poisoning and produces gastrointestinal diseases of 2 types: emetic and diarrheal. The emetic type, which is often linked to pasta and rice, arises from a preformed toxin, cereulide, in food. Rapid and accurate diagnostic methods for this emetic toxin are important but are limited. Here we describe 3 patients with B cereus food poisoning in which cereulide was detected and measured sequentially. Three family members began to vomit frequently 30 minutes after consuming reheated fried rice. After 6 hours, a 1-year-old brother died of acute encephalopathy. A 2-year-old sister who presented with unconsciousness recovered rapidly after plasma exchange and subsequent hemodialysis. Their mother recovered soon by fluid therapy. From leftover fried rice and the children's stomach contents, B cereus was isolated. Serum cereulide was detected in both children; it decreased to an undetected level in the sister. These cases highlight the importance of measuring the value of cereulide, which would reflect the severity of B cereus emetic food poisoning. The cases also suggest the possible role of blood-purification therapy in severe cases.
authors.affiliation: Kitano Hospital, Department of Pediatrics, 2-4-20, Ohgimachi, Kita-ku, Osaka City, Osaka, Japan. mi-shiota@kitano-hp.or.jp
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Shiota
authors.forename: Keiko
authors.initials: K
authors.lastname: Saitou
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mizumoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsusaka
authors.forename: Norio
authors.initials: N
authors.lastname: Agata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakayama
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kage
authors.forename: Shinji
authors.initials: S
authors.lastname: Tatsumi
authors.forename: Akira
authors.initials: A
authors.lastname: Okamoto
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Michio
authors.initials: M
authors.lastname: Ohta
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hata
mesh_terms: D000328:Adult; D001409:Bacillus cereus / Q000302:isolation & purification*; D001427:Bacterial Toxins / Q000097:blood*; D002675:Child, Preschool; D047630:Depsipeptides / Q000097:blood*; D017809:Fatal Outcome; D005260:Female; D005440:Fluid Therapy; D005517:Foodborne Diseases / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D020258:Neurotoxicity Syndromes / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D013997:Time Factors
chemical_list: D001427:Bacterial Toxins; D047630:Depsipeptides; C089294:cereulide