title: Bacillus cereus necrotizing pneumonia in a patient with nephrotic syndrome.
abstract: Bacillus cereus (B. cereus) is a Gram-positive rod that is widely distributed in the environment and can be a cause of food poisoning. We herein present a case of B. cereus necrotizing pneumonia in a patient with nephrotic syndrome under corticosteroid treatment after developing transient gastroenteritis symptoms. B. cereus was isolated from bronchial lavage fluid and transbronchial biopsy specimens. A multiplex polymerase chain reaction analysis of the toxin genes revealed a strain possessing enterotoxicity. The patient recovered after one week of intravenous meropenem followed by a combination of oral moxifloxacin and clindamycin. B. cereus is a pathogen that causes necrotizing pneumonia in immunocompromised hosts.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Miyata
authors.forename: Sadatomo
authors.initials: S
authors.lastname: Tasaka
authors.forename: Masaki
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Syuichi
authors.initials: S
authors.lastname: Yoshida
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Naoki
authors.forename: Koichi
authors.initials: K
authors.lastname: Sayama
authors.forename: Koichiro
authors.initials: K
authors.lastname: Asano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Ohkusu
authors.forename: Naoki
authors.initials: N
authors.lastname: Hasegawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Betsuyaku
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001372:Aza Compounds / Q000008:administration & dosage; D001409:Bacillus cereus / Q000276:immunology / Q000302:isolation & purification*; D001707:Biopsy, Needle; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D002981:Clindamycin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D024841:Fluoroquinolones; D005500:Follow-Up Studies; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007150:Immunohistochemistry; D008297:Male; D000077731:Meropenem; D000077266:Moxifloxacin; D009336:Necrosis / Q000473:pathology; D009404:Nephrotic Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D011804:Quinolines / Q000008:administration & dosage; D013902:Radiography, Thoracic / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D013845:Thienamycins / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D013845:Thienamycins; D002981:Clindamycin; D000077731:Meropenem; D000077266:Moxifloxacin