title: Bacillus cereus bacteremia and multiple brain abscesses during acute lymphoblastic leukemia induction therapy.
abstract: Bacillus cereus can cause serious infections in immunosuppressed patients. This population may be susceptible to B. cereus pneumonia, bacteremia, cellulitis, and rarely cerebral abscess. Here we report an 8-year-old boy undergoing induction therapy for acute lymphoblastic leukemia who developed multifocal B. cereus cerebral abscesses, highlighting the propensity for B. cereus to develop cerebral abscesses. A review of the literature over the past 25 years identified another 11 cases (3 children and 8 adults) of B. cereus cerebral abscess in patients undergoing cancer therapy. B. cereus cerebral abscesses were associated with a high mortality rate (42%) and significant morbidity. Notably, B. cereus bacteremia with concomitant cerebral abscess was associated with induction chemotherapy for acute leukemia in both children and adults (10 of 12 case reports). Our case report and review of the literature highlights the propensity for B. cereus to develop cerebral abscess(es). Therefore, early consideration for neuroimaging should be given for any neutropenic cancer patient identified with B. cereus bacteremia, in particular those with acute leukemia during induction therapy.
authors.affiliation: *Department of Hematology and Oncology, Princess Margaret Hospital for Children †School of Pediatrics and Child Health University of Western Australia ‡PathWest §Department of Pediatric and Adolescent Medicine, Princess Margaret Hospital ∥Telethon Institute for Child Health Research, Centre for Child Health Research, Perth, WA, Australia.
authors.forename: Jordan R
authors.initials: JR
authors.lastname: Hansford
authors.forename: Marianne
authors.initials: M
authors.lastname: Phillips
authors.forename: Catherine
authors.initials: C
authors.lastname: Cole
authors.forename: Joshua
authors.initials: J
authors.lastname: Francis
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Blyth
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Gottardo
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage; D001409:Bacillus cereus / Q000472:pathogenicity*; D016470:Bacteremia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D001922:Brain Abscess / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D003907:Dexamethasone / Q000008:administration & dosage; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009894:Opportunistic Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D011092:Polyethylene Glycols / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D011379:Prognosis; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D011092:Polyethylene Glycols; D014750:Vincristine; C042705:pegaspargase; D003907:Dexamethasone; D001215:Asparaginase