title: Lifesaving liver transplantation for multi-organ failure caused by Bacillus cereus food poisoning.
abstract: Bacillus cereus is a spore-forming, gram-positive bacterium that causes food poisoning presenting with either emesis or diarrhea. Diarrhea is caused by proteinaceous enterotoxin complexes, mainly hemolysin BL, non-hemolytic enterotoxin (NHE), and cytotoxin K. In contrast, emesis is caused by the ingestion of the depsipeptide toxin cereulide, which is produced in B. cereus contaminated food, particularly in pasta or rice. In general, the illness is mild and self-limiting. However, due to cereulide intoxication, nine severe cases with rhabdomyolysis and/or liver failure, five of them lethal, are reported in literature. Here we report the first case of life-threatening liver failure and severe rhabdomyolysis in this context that could not be survived without emergency hepatectomy and consecutive liver transplantation.
authors.affiliation: Department of Pediatrics 1, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Tschiedel
authors.forename: Peter-Michael
authors.initials: PM
authors.lastname: Rath
authors.forename: Jörg
authors.initials: J
authors.lastname: Steinmann
authors.forename: Heinz
authors.initials: H
authors.lastname: Becker
authors.forename: Rudolf
authors.initials: R
authors.lastname: Dietrich
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Ursula
authors.initials: U
authors.lastname: Felderhoff-Müser
authors.forename: Christian
authors.initials: C
authors.lastname: Dohna-Schwake
mesh_terms: D000293:Adolescent; D001409:Bacillus cereus; D004638:Emergency Treatment; D005517:Foodborne Diseases / Q000382:microbiology* / Q000601:surgery*; D016908:Gram-Positive Bacterial Infections / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D017093:Liver Failure / Q000382:microbiology* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male
keywords: acute liver failure; fulminant hepatic failure; living donor liver transplantation; pediatric liver transplantation