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

BMJ Case Rep. 2017 Oct 10:2017:bcr2017219996. doi: 10.1136/bcr-2017-219996.

Abstract

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.

Keywords: haematology (incl blood transfusion); infectious diseases; stroke.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / adverse effects*
  • Azacitidine / adverse effects*
  • Bacillus cereus*
  • Fatal Outcome
  • Hemorrhagic Septicemia / chemically induced
  • Hemorrhagic Septicemia / immunology
  • Hemorrhagic Septicemia / microbiology*
  • Humans
  • Immunocompromised Host
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / immunology
  • Male
  • Multiple Organ Failure / chemically induced
  • Multiple Organ Failure / immunology
  • Multiple Organ Failure / microbiology*

Substances

  • Antimetabolites, Antineoplastic
  • Azacitidine