title: Critical illness polyneuropathy and myopathy caused by Bacillus cereus sepsis in acute lymphoblastic leukemia.
abstract: We report a pediatric case of critical illness polyneuropathy and myopathy caused by Bacillus cereus sepsis during acute lymphoblastic leukemia therapy. A 15-year-old boy developed B. cereus sepsis and multiple organ failure on the 19th day after initiation of chemotherapy, and multidisciplinary treatment was started. Treatment was effective and septic shock with multiple organ failure remitted. He was weaned from a respirator on day 23 after the onset of sepsis, but complete flaccid paralysis of the 4 extremities occurred. His compound muscle action potential and F-wave occurrence were reduced on a nerve conduction test. The number of motor units was markedly decreased, and the amplitude and duration of individual motor units were low and short, respectively, on electromyography. Cerebrospinal fluid was normal. On the basis of these findings, he was diagnosed with critical illness polyneuropathy/myopathy. He underwent intensive rehabilitation and recovered the ability to walk 3 months after onset. He was discharged 1 year after the initiation of chemotherapy, and remission has been maintained without inconvenience to daily living activities for 3 years since disease onset.
authors.affiliation: Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirabayashi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Shiohara
authors.forename: Takefumi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Shoji
authors.initials: S
authors.lastname: Saito
authors.forename: Miyuki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Ryu
authors.initials: R
authors.lastname: Yanagisawa
authors.forename: Goro
authors.initials: G
authors.lastname: Tsuruta
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Fukuyama
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Hidaka
authors.forename: Yozo
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimizu
authors.forename: Kazuo
authors.initials: K
authors.lastname: Sakashita
authors.forename: Kenichi
authors.initials: K
authors.lastname: Koike
mesh_terms: D000293:Adolescent; D001409:Bacillus cereus / Q000472:pathogenicity*; D004576:Electromyography; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure; D009135:Muscular Diseases / Q000175:diagnosis / Q000209:etiology*; D011115:Polyneuropathies / Q000175:diagnosis / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000382:microbiology* / Q000628:therapy; D018805:Sepsis / Q000150:complications*