A patient with acute myeloid leukemia who developed fatal pneumonia caused by carbapenem-resistant Bacillus cereus

J Infect Chemother. 2009 Feb;15(1):39-41. doi: 10.1007/s10156-008-0654-8. Epub 2009 Mar 12.

Abstract

Bacillus cereus is known as a serious bacterial pathogen in neutropenic patients. B. cereus is often resistant to beta-lactams, including penicillins and cephalosporins. We report a case of fatal pneumonia caused by B. cereus in a patient with newly diagnosed acute myeloid leukemia (AML) during remission induction therapy. Cefepime was started for febrile neutropenia (FN) initially and was switched to panipem/betamipron, when fulminant pneumonia supervened. The isolated strain was resistant not only to cefepime but also to panipenem/betamipron. This is the first report of fulminant infection caused by carbapenem-resistant B. cereus in a neutropenic patient. B. cereus should be kept in mind as a target of empirical treatment when neutropenic patients develop pneumonia.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bacillaceae Infections / complications
  • Bacillaceae Infections / drug therapy
  • Bacillaceae Infections / microbiology*
  • Bacillus cereus / drug effects*
  • Bacillus cereus / isolation & purification
  • Carbapenems / pharmacology*
  • Carbapenems / therapeutic use
  • Fatal Outcome
  • Humans
  • Immunocompromised Host
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / diagnosis
  • Leukemia, Myeloid, Acute / drug therapy
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Neutropenia
  • Pneumonia, Bacterial / complications
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / microbiology*
  • Remission Induction
  • Tomography, X-Ray Computed
  • beta-Lactam Resistance*

Substances

  • Anti-Bacterial Agents
  • Antineoplastic Agents
  • Carbapenems