Rapid detoxification of cereulide in Bacillus cereus food poisoning.
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.
Shiota
Mitsutaka
M
Kitano Hospital, Department of Pediatrics, 2-4-20, Ohgimachi, Kita-ku, Osaka City, Osaka, Japan. mi-shiota@kitano-hp.or.jp
Saitou
Keiko
K
Mizumoto
Hiroshi
H
Matsusaka
Masanori
M
Agata
Norio
N
Nakayama
Masahiro
M
Kage
Masayoshi
M
Tatsumi
Shinji
S
Okamoto
Akira
A
Yamaguchi
Seiji
S
Ohta
Michio
M
Hata
Daisuke
D
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
D001427:Bacterial Toxins; D047630:Depsipeptides; C089294:cereulide