History

Fact Explanation
Symptoms of food poisoning (i.e. diarrhea and vomiting) Bacillus cereus is a Gram-positive aerobic or facultatively anaerobic, motile, spore-forming, rod-shaped bacterium. The main manifestation is food poisoning, which is frequently associated with the consumption of rice-based dishes. [1, 2] The multiplying bacteria produce emetic and diarrheal exotoxins. (i.e. exotoxins cereulide and the tripartite hemolysin BL ). [3, 4, 5] The food poisoning can present as an outbreak, when many people consumed the same contaminated food item. [6, 7] Nausea and abdominal cramps can also be associated with diarrhea and vomiting. [8]
Symptoms of eye infection. i.e. Eye pain following trauma to the eye Bacillus cereus is known to cause endophthalmitis, panophthalmitis, and keratitis following eye trauma. i.e. contact lens abrasions, blunt trauma. [2, 9, 10, 11, 12]
Symptoms of septicemia i.e. High fever, dizziness and yellow discoloration of eyes Due to B.cereus septicemia and associated hemolysis. [2, 13, 14, 15, 16]
Symptoms of lung infections i.e. Productive cough, chest pain and difficulty in breathing Due to B. cereus pneumonia, which can be necrotizing and fulminant, often yielding fatal outcomes. [17, 18, 19, 20, 21, 22]
Symptoms of meningitis i.e. Headache, seizures, visual disturbances, vomiting, fever and behavioral changes Due to B. cereus meningitis. Commoner in immunocompromised individuals and neonates. [2, 23, 24, 25, 26]
References
  1. BOTTONE EJ. Bacillus cereus, a volatile human pathogen. Clin Microbiol Rev [online] 2010 Apr, 23(2):382-98 [viewed 05 September 2014] Available from: doi:10.1128/CMR.00073-09
  2. DROBNIEWSKI FA. Bacillus cereus and related species. Clin Microbiol Rev [online] 1993 Oct, 6(4):324-38 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/8269390
  3. KIM JUNG-BEOM, JEONG HONG-RAE, PARK YONG-BAE, KIM JAE-MOUNG, OH DEOG-HWAN. Food Poisoning Associated with Emetic-Type of in Korea . Foodborne Pathogens and Disease [online] 2010 May, 7(5):555-563 [viewed 05 September 2014] Available from: doi:10.1089/fpd.2009.0443
  4. STENFORS ARNESEN LOTTE P., FAGERLUND ANNETTE, GRANUM PER EINAR. From soil to gut: and its food poisoning toxins . [online] 2008 July, 32(4):579-606 [viewed 05 September 2014] Available from: doi:10.1111/j.1574-6976.2008.00112.x
  5. GUINEBRETIèRE MH, BROUSSOLLE V, NGUYEN-THE C. Enterotoxigenic Profiles of Food-Poisoning and Food-Borne Bacillus cereus Strains J Clin Microbiol [online] 2002 Aug, 40(8):3053-3056 [viewed 05 September 2014] Available from: doi:10.1128/JCM.40.8.3053-3056.2002
  6. SLATEN DD, OROPEZA RI, WERNER SB. An outbreak of Bacillus cereus food poisoning--are caterers supervised sufficiently. Public Health Rep [online] 1992, 107(4):477-480 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403681
  7. DIERICK K, VAN COILLIE E, SWIECICKA I, MEYFROIDT G, DEVLIEGER H, MEULEMANS A, HOEDEMAEKERS G, FOURIE L, HEYNDRICKX M, MAHILLON J. Fatal Family Outbreak of Bacillus cereus-Associated Food Poisoning J Clin Microbiol [online] 2005 Aug, 43(8):4277-4279 [viewed 05 September 2014] Available from: doi:10.1128/JCM.43.8.4277-4279.2005
  8. HOLMES J. RICHARD. Emetic Food Poisoning Caused by Bacillus cereus. Arch Intern Med [online] 1981 May [viewed 05 September 2014] Available from: doi:10.1001/archinte.1981.00340060074016
  9. CALLEGAN MC, JETT BD, HANCOCK LE, GILMORE MS. Role of hemolysin BL in the pathogenesis of extraintestinal Bacillus cereus infection assessed in an endophthalmitis model. Infect Immun [online] 1999 Jul, 67(7):3357-66 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/10377113
  10. YANG CS, LU CK, LEE FL, HSU WM, LEE YF, LEE SM. Treatment and outcome of traumatic endophthalmitis in open globe injury with retained intraocular foreign body. Ophthalmologica [online] 2010, 224(2):79-85 [viewed 05 September 2014] Available from: doi:10.1159/000235725
  11. SCHEMMER G. B., DRIEBE W. T.. Posttraumatic Bacillus cereus Endophthalmitis. Archives of Ophthalmology [online] 1987 March, 105(3):342-344 [viewed 05 September 2014] Available from: doi:10.1001/archopht.1987.01060030062026
  12. PINNA ANTONIO, SECHI LEONARDO A, ZANETTI STEFANIA, USAI DONATELLA, DELOGU GIOVANNI, CAPPUCCINELLI PIERO, CARTA FRANCESCO. Bacillus cereus keratitis associated with contact lens wear1 1The authors have no financial interest in any material used in this study.. Ophthalmology [online] 2001 October, 108(10):1830-1834 [viewed 05 September 2014] Available from: doi:10.1016/S0161-6420(01)00723-0
  13. UCHINO Y, IRIYAMA N, MATSUMOTO K, HIRABAYASHI Y, MIURA K, KURITA D, KOBAYASHI Y, YAGI M, KODAIRA H, HOJO A, KOBAYASHI S, HATTA Y, TAKEUCHI J. A case series of Bacillus cereus septicemia in patients with hematological disease. Intern Med [online] 2012, 51(19):2733-8 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/23037464
  14. INOUE D, NAGAI Y, MORI M, NAGANO S, TAKIUCHI Y, ARIMA H, KIMURA T, SHIMOJI S, TOGAMI K, TABATA S, YANAGITA S, MATSUSHITA A, NAGAI K, IMAI Y, TAKEGAWA H, TAKAHASHI T. Fulminant sepsis caused by Bacillus cereus in patients with hematologic malignancies: analysis of its prognosis and risk factors. Leuk Lymphoma [online] 2010 May, 51(5):860-9 [viewed 05 September 2014] Available from: doi:10.3109/10428191003713976
  15. KIYOMIZU K, YAGI T, YOSHIDA H, MINAMI R, TANIMURA A, KARASUNO T, HIRAOKA A. Fulminant septicemia of Bacillus cereus resistant to carbapenem in a patient with biphenotypic acute leukemia. J Infect Chemother [online] 2008 Oct, 14(5):361-7 [viewed 05 September 2014] Available from: doi:10.1007/s10156-008-0627-y
  16. MUSA M.O., AL DOURI M., KHAN S., SHAFI T., AL HUMAIDH A., AL RASHEED A.M.. Fulminant Septicaemic Syndrome of Bacillus cereus: Three case reports. Journal of Infection [online] 1999 September, 39(2):154-156 [viewed 05 September 2014] Available from: doi:10.1016/S0163-4453(99)90009-9
  17. MILLER JM, HAIR JG, HEBERT M, HEBERT L, ROBERTS FJ JR, WEYANT RS. Fulminating bacteremia and pneumonia due to Bacillus cereus. J Clin Microbiol [online] 1997 Feb, 35(2):504-507 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC229612
  18. AVASHIA SB, RIGGINS WS, LINDLEY C, HOFFMASTER A, DRUMGOOLE R, NEKOMOTO T, JACKSON PJ, HILL KK, WILLIAMS K, LEHMAN L, LIBAL MC, WILKINS PP, ALEXANDER J, TVARYANAS A, BETZ T. Fatal pneumonia among metalworkers due to inhalation exposure to Bacillus cereus Containing Bacillus anthracis toxin genes. Clin Infect Dis [online] 2007 Feb 1, 44(3):414-6 [viewed 05 September 2014] Available from: doi:10.1086/510429
  19. MILLER JM, HAIR JG, HEBERT M, HEBERT L, ROBERTS FJ JR, WEYANT RS. Fulminating bacteremia and pneumonia due to Bacillus cereus. J Clin Microbiol [online] 1997 Feb, 35(2):504-7 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/9003628
  20. MIYATA J, TASAKA S, MIYAZAKI M, YOSHIDA S, NAOKI K, SAYAMA K, ASANO K, FUJIWARA H, OHKUSU K, HASEGAWA N, BETSUYAKU T. Bacillus cereus necrotizing pneumonia in a patient with nephrotic syndrome. Intern Med [online] 2013, 52(1):101-4 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/23291682
  21. GASCOIGNE AD, RICHARDS J, GOULD K, GIBSON GJ. Successful treatment of Bacillus cereus infection with ciprofloxacin. Thorax [online] 1991 Mar, 46(3):220-221 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC463053
  22. BACILLUS CEREUS AS A SYSTEMIC PATHOGEN. The Lancet [online] 1983 December [viewed 05 September 2014] Available from: doi:10.1016/S0140-6736(83)90812-7
  23. STEVENS MP, ELAM K, BEARMAN G. Meningitis due to Bacillus cereus: A case report and review of the literature Can J Infect Dis Med Microbiol [online] 2012, 23(1):e16-e19 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374474
  24. BARRIE D., WILSON J.A., HOFFMAN P.N., KRAMER J.M.. Bacillus cereus meningitis in two neuro surgical patients: An investigation into the source of the organism. Journal of Infection [online] 1992 November, 25(3):291-297 [viewed 05 September 2014] Available from: doi:10.1016/0163-4453(92)91579-Z
  25. LEBESSI EVANGELIA, DELLAGRAMMATICAS HERACLES D., ANTONAKI GEORGIA, FOUSTOUKOU MARIA, IACOVIDOU NICOLETTA. Array. J Matern Fetal Neonatal Med [online] 2009 January, 22(5):458-461 [viewed 05 September 2014] Available from: doi:10.1080/14767050802610336
  26. TOKIEDA K, MORIKAWA Y, MAEYAMA K, MORI K, IKEDA K. Clinical manifestations of meningitis in newborn infants . [online] December, 35(6):582-584 [viewed 05 September 2014] Available from: doi:10.1046/j.1440-1754.1999.00405.x

Examination

Fact Explanation
Features of dehydration. (i.e. dry mucus membranes, absence of sweating, sunken eyes.) Due to vomiting and diarrhea. [1, 2, 3, 4, 5, 6, 7]
Red eye Due to eye infections. i.e. endophthalmitis, panophthalmitis, and keratitis. [2, 8, 9, 10, 11]
High fever Due to inflammatory response in B. cereus septicemia. [1, 12]
Low blood pressure and tachycardia Due to septic shock. [13, 14, 15, 16]
Signs of pulmonary consolidation i.e. reduced air entry, reduced lung expansion, coarse crepitations Due to B. cereus pneumonia. [17, 18, 19, 20, 21, 22]
References
  1. BOTTONE EJ. Bacillus cereus, a volatile human pathogen. Clin Microbiol Rev [online] 2010 Apr, 23(2):382-98 [viewed 05 September 2014] Available from: doi:10.1128/CMR.00073-09
  2. DROBNIEWSKI FA. Bacillus cereus and related species. Clin Microbiol Rev [online] 1993 Oct, 6(4):324-38 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/8269390
  3. KIM JUNG-BEOM, JEONG HONG-RAE, PARK YONG-BAE, KIM JAE-MOUNG, OH DEOG-HWAN. Food Poisoning Associated with Emetic-Type of in Korea . Foodborne Pathogens and Disease [online] 2010 May, 7(5):555-563 [viewed 05 September 2014] Available from: doi:10.1089/fpd.2009.0443
  4. SPEROTTO G, CARRAZZA FR, MARCONDES E. Treatment of diarrheal dehydration. Am J Clin Nutr [online] 1977 Sep, 30(9):1447-56 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/331933
  5. Dehydration and diarrhea Paediatr Child Health [online] 2003 Sep, 8(7):459-460 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791660
  6. Manual for the Health Care of Children in Humanitarian Emergencies: 3 Diarrhoea and dehydration. [web] [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/books/NBK143745/
  7. Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger than 5 Years: Assessing dehydration and shock. [web] [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/books/NBK63845/
  8. CALLEGAN MC, JETT BD, HANCOCK LE, GILMORE MS. Role of hemolysin BL in the pathogenesis of extraintestinal Bacillus cereus infection assessed in an endophthalmitis model. Infect Immun [online] 1999 Jul, 67(7):3357-66 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/10377113
  9. YANG CS, LU CK, LEE FL, HSU WM, LEE YF, LEE SM. Treatment and outcome of traumatic endophthalmitis in open globe injury with retained intraocular foreign body. Ophthalmologica [online] 2010, 224(2):79-85 [viewed 05 September 2014] Available from: doi:10.1159/000235725
  10. SCHEMMER G. B., DRIEBE W. T.. Posttraumatic Bacillus cereus Endophthalmitis. Archives of Ophthalmology [online] 1987 March, 105(3):342-344 [viewed 05 September 2014] Available from: doi:10.1001/archopht.1987.01060030062026
  11. PINNA ANTONIO, SECHI LEONARDO A, ZANETTI STEFANIA, USAI DONATELLA, DELOGU GIOVANNI, CAPPUCCINELLI PIERO, CARTA FRANCESCO. Bacillus cereus keratitis associated with contact lens wear1 1The authors have no financial interest in any material used in this study.. Ophthalmology [online] 2001 October, 108(10):1830-1834 [viewed 05 September 2014] Available from: doi:10.1016/S0161-6420(01)00723-0
  12. GURLER N, OKSUZ L, MUFTUOGLU M, SARGIN F, BESISIK S. Bacillus Cereus Catheter Related Bloodstream Infection in a Patient with Acute Lymphoblastic Leukemia Mediterr J Hematol Infect Dis [online] , 4(1):e2012004 [viewed 06 September 2014] Available from: doi:10.4084/MJHID.2012.004
  13. HIRABAYASHI K, SHIOHARA M, SUZUKI T, SAITO S, TANAKA M, YANAGISAWA R, TSURUTA G, FUKUYAMA T, HIDAKA Y, NAKAZAWA Y, SHIMIZU T, SAKASHITA K, KOIKE K. Critical illness polyneuropathy and myopathy caused by Bacillus cereus sepsis in acute lymphoblastic leukemia. J Pediatr Hematol Oncol [online] 2012 Apr, 34(3):e110-3 [viewed 06 September 2014] Available from: doi:10.1097/MPH.0b013e318234620b
  14. INOUE D, NAGAI Y, MORI M, NAGANO S, TAKIUCHI Y, ARIMA H, KIMURA T, SHIMOJI S, TOGAMI K, TABATA S, YANAGITA S, MATSUSHITA A, NAGAI K, IMAI Y, TAKEGAWA H, TAKAHASHI T. Fulminant sepsis caused by Bacillus cereus in patients with hematologic malignancies: analysis of its prognosis and risk factors. Leuk Lymphoma [online] 2010 May, 51(5):860-9 [viewed 06 September 2014] Available from: doi:10.3109/10428191003713976
  15. DE MEDEIROS CR, FAORO LN, FRIEDRICH ML, PEREIRA N, CUNHA CA, PASQUINI R. Unrelated bone marrow as a source of Bacillus cereus causing septic shock. Bone Marrow Transplant [online] 2000 Dec, 26(11):1259-60 [viewed 06 September 2014] Available from: doi:10.1038/sj.bmt.1702704
  16. GINSBURG AMY S., SALAZAR LUPE G., TRUE LAWRENCE D., DISIS MARY L.. FatalBacillus cereus sepsis following resolving neutropenic enterocolitis during the treatment of acute leukemia. Am. J. Hematol. [online] December, 72(3):204-208 [viewed 06 September 2014] Available from: doi:10.1002/ajh.10272
  17. MILLER JM, HAIR JG, HEBERT M, HEBERT L, ROBERTS FJ JR, WEYANT RS. Fulminating bacteremia and pneumonia due to Bacillus cereus. J Clin Microbiol [online] 1997 Feb, 35(2):504-507 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC229612
  18. AVASHIA SB, RIGGINS WS, LINDLEY C, HOFFMASTER A, DRUMGOOLE R, NEKOMOTO T, JACKSON PJ, HILL KK, WILLIAMS K, LEHMAN L, LIBAL MC, WILKINS PP, ALEXANDER J, TVARYANAS A, BETZ T. Fatal pneumonia among metalworkers due to inhalation exposure to Bacillus cereus Containing Bacillus anthracis toxin genes. Clin Infect Dis [online] 2007 Feb 1, 44(3):414-6 [viewed 05 September 2014] Available from: doi:10.1086/510429
  19. MILLER JM, HAIR JG, HEBERT M, HEBERT L, ROBERTS FJ JR, WEYANT RS. Fulminating bacteremia and pneumonia due to Bacillus cereus. J Clin Microbiol [online] 1997 Feb, 35(2):504-7 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/9003628
  20. MIYATA J, TASAKA S, MIYAZAKI M, YOSHIDA S, NAOKI K, SAYAMA K, ASANO K, FUJIWARA H, OHKUSU K, HASEGAWA N, BETSUYAKU T. Bacillus cereus necrotizing pneumonia in a patient with nephrotic syndrome. Intern Med [online] 2013, 52(1):101-4 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/23291682
  21. GASCOIGNE AD, RICHARDS J, GOULD K, GIBSON GJ. Successful treatment of Bacillus cereus infection with ciprofloxacin. Thorax [online] 1991 Mar, 46(3):220-221 [viewed 05 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC463053
  22. BACILLUS CEREUS AS A SYSTEMIC PATHOGEN. The Lancet [online] 1983 December [viewed 05 September 2014] Available from: doi:10.1016/S0140-6736(83)90812-7

Differential Diagnoses

Fact Explanation
Food poisoning due to other microbes Other common microbes that cause food poisoning are Staphylococcus aureus, Escerichia coli, Clostridium botulinum, Clostridium perfringens and Campylobacter enteritis. The clinical features of food poisoning can be similar in all causative organisms, but microbiological studies can help in differentiating. [1, 2, 3, 4, 5, 6, ,7, 8, 9]
Bacterial gastroenteritis Gastroenteritis can have similar clinical features of food poisoning, i.e. vomiting, diarrhea and abdominal pain. But the course of illness can be more severe in gastroenteritis, since the symptoms are due to active infection rather than pre-formed toxins. The common causative microbes are E. coli, Salmonella, Campylobacter. [10, 11, 12, 13]
Eye infection due to other microbes The common cause of eye infections are Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. Microbiological studies i.e. culture and Gram stain will confirm the organism. [14, 15, 16, 17, 18, 19, 20]
Bacterial pneumonia The microbes that cause pneumonia are widely variant, sputum culture is the standard method of diagnosis. [21, 22, 23, 24]
Bacterial meningitis The common causes for bacterial meningitis are N. meningitidis, Streptococcus pneumoniae and H. influenzae. Cerebrospinal fluid for microbiological studies can confirm the organism. [25. 26, 27]
References
  1. HELSTAD AG, MANDEL AD, EVANS AS. Thermostable Clostridium perfringens as cause of food poisoning outbreak. Public Health Rep [online] 1967 Feb, 82(2):157-161 [viewed 06 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1919992
  2. HODGE BE. Control of staphylococcal food poisoning Public Health Rep [online] 1960 Apr, 75(4):355-361 [viewed 06 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1929443
  3. LAWRENCE DAVID T., DOBMEIER STEPHEN G., BECHTEL LAURA K., HOLSTEGE CHRISTOPHER P.. Food Poisoning. Emergency Medicine Clinics of North America [online] 2007 May, 25(2):357-373 [viewed 06 September 2014] Available from: doi:10.1016/j.emc.2007.02.014
  4. JOHANSSON ANDERS, ASPAN ANNA, BAGGE ELISABETH, BåVERUD VIVECA, ENGSTRöM BJöRN E, JOHANSSON KARL-ERIK. . BMC Microbiol [online] 2006 December [viewed 06 September 2014] Available from: doi:10.1186/1471-2180-6-47
  5. ARGUDíN MARíA ÁNGELES, MENDOZA MARíA CARMEN, RODICIO MARíA ROSARIO. Food Poisoning and Staphylococcus aureus Enterotoxins. Toxins [online] 2010 July, 2(7):1751-1773 [viewed 06 September 2014] Available from: doi:10.3390/toxins2071751
  6. GRANUM PER EINAR, TOMAS JUAN M., ALOUF JOSEPH E.. A survey of bacterial toxins involved in food poisoning: a suggestion for bacterial food poisoning toxin nomenclature. International Journal of Food Microbiology [online] 1995 December, 28(2):129-144 [viewed 06 September 2014] Available from: doi:10.1016/0168-1605(95)00052-6
  7. AL-GOBLAN ABDULLAH SALEH, JAHAN SAULAT. Surveillance for Foodborne Illness Outbreaks in Qassim, Saudi Arabia, 2006. Foodborne Pathogens and Disease [online] 2010 December, 7(12):1559-1562 [viewed 06 September 2014] Available from: doi:10.1089/fpd.2010.0638
  8. MEAD PAUL. Food-Related Illness and Death in the United States. Emerg. Infect. Dis. [online] 1999 October, 5(5):607-625 [viewed 06 September 2014] Available from: doi:10.3201/eid0505.990502
  9. OLLINGER-SNYDER PATRICIA, MATTHEWS M.EILEEN. Food safety. Journal of the American Dietetic Association [online] 1996 February, 96(2):163-171 [viewed 06 September 2014] Available from: doi:10.1016/S0002-8223(96)00046-6
  10. CHAN SS, NG KC, LYON DJ, CHEUNG WL, CHENG AF, RAINER TH. Acute bacterial gastroenteritis: a study of adult patients with positive stool cultures treated in the emergency department. Emerg Med J [online] 2003 Jul, 20(4):335-8 [viewed 06 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/12835343
  11. O'RYAN M, LUCERO Y, O'RYAN-SORIANO MA, ASHKENAZI S. An update on management of severe acute infectious gastroenteritis in children. Expert Rev Anti Infect Ther [online] 2010 Jun, 8(6):671-82 [viewed 06 September 2014] Available from: doi:10.1586/eri.10.40
  12. RODRíGUEZ LUIS ALBERTO GARCíA, RUIGóMEZ ANA, PANéS JULIáN. Acute Gastroenteritis Is Followed by an Increased Risk of Inflammatory Bowel Disease. Gastroenterology [online] 2006 May, 130(6):1588-1594 [viewed 06 September 2014] Available from: doi:10.1053/j.gastro.2006.02.004
  13. JANSEN ANDREAS, STARK KLAUS, KUNKEL JAN, SCHREIER ECKART, IGNATIUS RALF, LIESENFELD OLIVER, WERBER DIRK, GöBEL ULF B, ZEITZ MARTIN, SCHNEIDER THOMAS. Aetiology of community-acquired, acute gastroenteritis in hospitalised adults: a prospective cohort study. Array [online] 2008 December [viewed 06 September 2014] Available from: doi:10.1186/1471-2334-8-143
  14. BHARATHI MJAYAHAR, AMUTHAN M, VISWANATHAN S, RAMESH S, RAMAKRISHNAN R. Prevalence of bacterial pathogens causing ocular infections in South India. Indian J Pathol Microbiol [online] 2010 December [viewed 06 September 2014] Available from: doi:10.4103/0377-4929.64336
  15. MAHAJAN VM. Acute bacterial infections of the eye: their aetiology and treatment. Br J Ophthalmol [online] 1983 Mar, 67(3):191-194 [viewed 06 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1040006
  16. HUTNIK C, MOHAMMAD-SHAHI MH. Bacterial conjunctivitis Clin Ophthalmol [online] 2010:1451-1457 [viewed 06 September 2014] Available from: doi:10.2147/OPTH.S10162
  17. TARABISHY A. B., JENG B. H.. Bacterial conjunctivitis: A review for internists. Cleveland Clinic Journal of Medicine [online] 2008 July, 75(7):507-512 [viewed 06 September 2014] Available from: doi:10.3949/ccjm.75.7.507
  18. SHARMA S. Ocular infections: Research in India. Indian J Med Microbiol [online] 2010 December [viewed 06 September 2014] Available from: doi:10.4103/0255-0857.62481
  19. WONG RAYMOND L. M., GANGWANI R. A., YU LESTER W. H., LAI JIMMY S. M.. New Treatments for Bacterial Keratitis. Journal of Ophthalmology [online] 2012 December, 2012:1-7 [viewed 06 September 2014] Available from: doi:10.1155/2012/831502
  20. Conjunctivitis (Pink eye). [web] [viewed 06 September 2014] Available from: http://www.cdc.gov/conjunctivitis/clinical.html
  21. AMIN AN, CERCEO EA, DEITELZWEIG SB, PILE JC, ROSENBERG DJ, SHERMAN BM. The hospitalist perspective on treatment of community-acquired bacterial pneumonia. Postgrad Med [online] 2014 Mar, 126(2):18-29 [viewed 06 September 2014] Available from: doi:10.3810/pgm.2014.03.2737
  22. WUNDERINK RICHARD G. Influenza and bacterial pneumonia - constant companions. Array [online] 2010 December [viewed 06 September 2014] Available from: doi:10.1186/cc8974
  23. Pneumonia. [web] [viewed 06 September 2014] Available from: http://www.cdc.gov/pneumonia/
  24. GUPTA RAVINDRA K., GEORGE ROBERT, NGUYEN-VAN-TAM JONATHAN S.. Bacterial Pneumonia and Pandemic Influenza Planning. Emerg. Infect. Dis. [online] 2008 August, 14(8):1187-1192 [viewed 06 September 2014] Available from: doi:10.3201/eid1408.070751
  25. LIN ANDREW L., SAFDIEH JOSEPH E.. The Evaluation and Management of Bacterial Meningitis. The Neurologist [online] 2010 May, 16(3):143-151 [viewed 06 September 2014] Available from: doi:10.1097/NRL.0b013e3181d14185
  26. HOFFMAN O, WEBER RJ. Pathophysiology and Treatment of Bacterial Meningitis Ther Adv Neurol Disord [online] 2009 Nov, 2(6):1-7 [viewed 06 September 2014] Available from: doi:10.1177/1756285609337975
  27. SáEZ-LLORENS X, MCCRACKEN GH JR. Bacterial meningitis in children. Lancet [online] 2003 Jun 21, 361(9375):2139-48 [viewed 06 September 2014] Available from: doi:10.1016/S0140-6736(03)13693-8

Investigations - for Diagnosis

Fact Explanation
Microbiological culture of swabs Culture under aerobic conditions on 5% sheep blood agar at 37°C, skin gangrenes yield B. cereus colonies that are dull gray and opaque with a rough matted surface. [1] Colony perimeters are irregular and represent the configuration of swarming from the site of initial inoculation, perhaps due to B. cereus swarming motility. [2] There are zones of discontinuous beta-hemolysis surround and conform to the colony morphology. [3, 4, 5]
Gram stain Swabs, aspirates can be used for Gram staining as well as culture colonies. [1] B. cereus are straight or slightly curved slender bacilli with square ends singly or in short chains. There are distinct junctions separating members of the chain. Gram-stained smears prepared from agar growth will show more uniform bacillary morphology with oval,The spores if present, are centrally situated and do not distort the bacillary form. [6, 7, 8, 9]
Antibiotic Sensitivity Becasue most of the B. cereus strains are resistant to penillins and cephalosporins since they produce beta-lactamases, and erythromycin, tetracycline, carbapenem has also been reported. [1, 10]
References
  1. BOTTONE EJ. Bacillus cereus, a Volatile Human Pathogen Clin Microbiol Rev [online] 2010 Apr, 23(2):382-398 [viewed 07 September 2014] Available from: doi:10.1128/CMR.00073-09
  2. SENESI S, CELANDRONI F, SALVETTI S, BEECHER DJ, WONG AC, GHELARDI E. Swarming motility in Bacillus cereus and characterization of a fliY mutant impaired in swarm cell differentiation. Microbiology [online] 2002 Jun, 148(Pt 6):1785-94 [viewed 07 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/12055298
  3. PHELPS RJ, MCKILLIP JL. Enterotoxin Production in Natural Isolates of Bacillaceae outside the Bacillus cereus Group Appl Environ Microbiol [online] 2002 Jun, 68(6):3147-3151 [viewed 07 September 2014] Available from: doi:10.1128/AEM.68.6.3147-3151.2002
  4. PRüß BM, DIETRICH R, NIBLER B, MäRTLBAUER E, SCHERER S. The Hemolytic Enterotoxin HBL Is Broadly Distributed among Species of the Bacillus cereus Group Appl Environ Microbiol [online] 1999 Dec, 65(12):5436-5442 [viewed 07 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC91741
  5. HILLIARD N. J., SCHELONKA R. L., WAITES K. B.. Bacillus cereus Bacteremia in a Preterm Neonate. Journal of Clinical Microbiology [online] 2003 July, 41(7):3441-3444 [viewed 07 September 2014] Available from: doi:10.1128/JCM.41.7.3441-3444.2003
  6. KOTIRANTA ANJA K., ITO HITOSHI, HAAPASALO MARKUS P.P., LOUNATMAA KARI. Radiation sensitivity of with and without a crystalline surface protein layer . [online] 1999 October, 179(2):275-280 [viewed 07 September 2014] Available from: doi:10.1111/j.1574-6968.1999.tb08738.x
  7. DIB ELIE G., DIB SAMAR A., KORKMAZ DANY A., MOBARAKAI NEVILLE K., GLASER JORDAN B.. Nonhemolytic, Nonmotile Gram-Positive Rods Indicative of . Emerg. Infect. Dis. [online] 2003 August, 9(8):1013-1015 [viewed 07 September 2014] Available from: doi:10.3201/eid0908.030205
  8. SANKARARAMAN S., VELAYUTHAN S.. Bacillus Cereus. Pediatrics in Review [online] December, 34(4):196-197 [viewed 07 September 2014] Available from: doi:10.1542/pir.34-4-196
  9. RISHI EKTA, RISHI PUKHRAJ, SENGUPTA SABYASACHI, JAMBULINGAM MALATHI, MADHAVAN HAJIB N., GOPAL LINGAM, THERESE K. LILY. Acute Postoperative Bacillus cereus Endophthalmitis Mimicking Toxic Anterior Segment Syndrome. Ophthalmology [online] 2013 January, 120(1):181-185 [viewed 07 September 2014] Available from: doi:10.1016/j.ophtha.2012.07.009
  10. DROBNIEWSKI FA. Bacillus cereus and related species. Clin Microbiol Rev [online] 1993 Oct, 6(4):324-338 [viewed 07 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC358292

Management - General Measures

Fact Explanation
Empirical antibiotic therapy With Clindamycin plus gentamicin or vancomycin before the results of ABST arrives, because in cases of eye infection and systemic infection, the outcome will be disastrous unless treated aggressively. Imipenum can also be used. The empirical treatment should be used in whatever the route needed, topical, oral, intravenous, even intrathecal. [1, 2]
Specific antibiotic thereapy Once the ABST results arrive, the antibiotics can be changed according to the results. Pulmonary infections with bronchiectasis has been treated successfully with Ciprofloxacin. [2, 3, 4, 5, 6, 7] The usual antibiotics that B. cereus is sussceptible to are imipenem, vancomycin, chloramphenicol, gentamicin and ciprofloxacin. [8]
References
  1. BOTTONE EJ. Bacillus cereus, a Volatile Human Pathogen Clin Microbiol Rev [online] 2010 Apr, 23(2):382-398 [viewed 07 September 2014] Available from: doi:10.1128/CMR.00073-09
  2. DROBNIEWSKI FA. Bacillus cereus and related species. Clin Microbiol Rev [online] 1993 Oct, 6(4):324-338 [viewed 07 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC358292
  3. GASCOIGNE AD, RICHARDS J, GOULD K, GIBSON GJ. Successful treatment of Bacillus cereus infection with ciprofloxacin. Thorax [online] 1991 Mar, 46(3):220-221 [viewed 07 September 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC463053
  4. HAASE ROLAND, SAUER HARALD, DAGWADORDSCH URANTSCHIMEG, FOELL JüRGEN, LIESER ULLA. Successful treatment of meningitis following allogenic stem cell transplantation . [online] 2005 June, 9(3):338-341 [viewed 07 September 2014] Available from: doi:10.1111/j.1399-3046.2004.00286.x
  5. KEMMERLY S. A., PANKEY G. A.. Oral Ciprofloxacin Therapy for Bacillus cereus Wound Infection and Bacteremia. Clinical Infectious Diseases [online] 1993 January, 16(1):189-189 [viewed 07 September 2014] Available from: doi:10.1093/clinids/16.1.189
  6. ABUSIN SALAHELDIN, BHIMARAJ ARVIND, KHADRA SUHAIL. Bacillus Cereus Endocarditis in a permanent pacemaker: a case report. Array [online] 2008 December [viewed 07 September 2014] Available from: doi:10.1186/1757-1626-1-95
  7. FRANKARD J., LI R., TACCONE F., STRUELENS M.J., JACOBS F., KENTOS A.. Bacillus cereus pneumonia in a patient with acute lymphoblastic leukemia. Eur J Clin Microbiol Infect Dis [online] December [viewed 07 September 2014] Available from: doi:10.1007/s10096-004-1180-y
  8. TUAZON C.U. Bacillus species. [web] [viewed 07 September 2014] Available from: http://www.antimicrobe.org/new/b82.asp