Survival of community-acquired Bacillus cereus sepsis with venous sinus thrombosis in an immunocompetent adult man - a case report and literature review.

Abstract

BACKGROUND:

Bacillus cereus infections in immunocompetent patients are uncommon and mainly observed in fragile patients. It can cause lethal infections with multiple organ dysfunction syndrome (MODS). However, a patient presenting as venous sinus thrombosis and survival without sequela has not been reported.

CASE PRESENTATION:

A 20-year-old previously healthy male developed gastroenteritis after a meal, followed by fever, convulsions, and severe disturbance of consciousness. The patient had significant leukocytosis with a mildly elevated D-dimer, creatinine level, and respiratory failure. The CT(computed tomography) revealed fatal brain edema and subarachnoid hemorrhage. Previous blood culture in a local hospital revealed B. cereus, which was confirmed by mNGS(metagenomic next-generation sequencing) using blood and urine in our hospital. Accordingly, B. cereus sepsis with MODS were considered. Later, cerebral venous sinus thrombosis was proved. After anti-infection (linezolid 0.6 g, Q12h; and meropenem 1.0 g, Q8h), anti-coagulant (enoxaparin 6000U, Q12h), and other symptomatic treatments, the patient recovered completely without sequela at the 6-month follow-up.

CONCLUSIONS:

This case suggests that in immunocompetent adults, there is still a risk of infection with B. cereus, causing severe MODS. Special attention should be paid to venous sinus thrombosis and subarachnoid hemorrhage in such cases, while, anti-coagulant is essential therapy.

• Authors: Zengrong Wang, Han Xia, Fangfang Fan, Jin Zhang, Hong Liu, Jing Cao
• Journal: BMC infectious diseases (BMC Infect Dis) Vol. 23 Issue 1 Pg. 213 (Apr 06 2023) ISSN: 1471-2334 [Electronic] England
• PMID: 37024789 (Publication Type: Review, Case Reports, Journal Article)
• Copyright: © 2023. The Author(s).

Topics

• Humans
• Male
• Adult
• Young Adult
• Subarachnoid Hemorrhage (etiology)
• Bacillus cereus
• Sepsis (complications, diagnosis, drug therapy)
• Sinus Thrombosis, Intracranial (complications)