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BMJ Case Reports 2017; doi:10.1136/bcr-2017-219996
  • Reminder of important clinical lesson
  • CASE REPORT

Fulminant Bacillus cereus septicaemia with multiple organ ischaemic/haemorrhagic complications in a patient undergoing chemotherapy for acute myelogenous leukaemia

  1. Yoshio Suzuki3
  1. 1Department of Hematology, Asahi General Hospital, Asahi, Japan
  2. 2Department of Cardiology, Asahi General Hospital, Asahi, Japan
  3. 3Department of Pathology, Asahi General Hospital, Asahi, Japan
  1. Correspondence to Dr Yusuke S Hori, ys-hori{at}umin.ac.jp
  • Accepted 29 September 2017
  • Published 10 October 2017

Summary

Bacillus cereus is a Gram-positive spore-forming rod widely found in the environment and is thought to be a frequent source of contamination. This micro-organism is reportedly a significant pathogenic agent among immunocompromised individuals. Furthermore, multiple cases of fulminant septicaemia have been reported among individuals receiving chemotherapy for acute myelogenous leukaemia. In some cases, B. cereus septicaemia was associated with multiple haemorrhages. We, herein, describe a patient with an extremely acute course of B. cereus septicaemia characterised by haemorrhage and infarction of multiple organs, which led to his death. Our findings suggest that delayed treatment of B. cereus in patients with haematologic malignancies undergoing chemotherapy may result in extremely poor outcomes; thus, immediate empirical treatment with vancomycin should be considered.

Footnotes

  • Contributors YSH wrote the manuscript. SK, YN and YS critically reviewed it.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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