Bacillus cereus necrotizing pneumonia in a patient with nephrotic syndrome

Intern Med. 2013;52(1):101-4. doi: 10.2169/internalmedicine.52.7282. Epub 2013 Jan 1.

Abstract

Bacillus cereus (B. cereus) is a Gram-positive rod that is widely distributed in the environment and can be a cause of food poisoning. We herein present a case of B. cereus necrotizing pneumonia in a patient with nephrotic syndrome under corticosteroid treatment after developing transient gastroenteritis symptoms. B. cereus was isolated from bronchial lavage fluid and transbronchial biopsy specimens. A multiplex polymerase chain reaction analysis of the toxin genes revealed a strain possessing enterotoxicity. The patient recovered after one week of intravenous meropenem followed by a combination of oral moxifloxacin and clindamycin. B. cereus is a pathogen that causes necrotizing pneumonia in immunocompromised hosts.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Aza Compounds / administration & dosage
  • Bacillus cereus / immunology
  • Bacillus cereus / isolation & purification*
  • Biopsy, Needle
  • Bronchoalveolar Lavage Fluid / cytology
  • Clindamycin / administration & dosage
  • Drug Therapy, Combination
  • Fluoroquinolones
  • Follow-Up Studies
  • Gram-Positive Bacterial Infections / complications
  • Gram-Positive Bacterial Infections / diagnosis*
  • Gram-Positive Bacterial Infections / immunology
  • Humans
  • Immunocompromised Host*
  • Immunohistochemistry
  • Male
  • Meropenem
  • Moxifloxacin
  • Necrosis / pathology
  • Nephrotic Syndrome / complications
  • Nephrotic Syndrome / diagnosis
  • Nephrotic Syndrome / drug therapy
  • Nephrotic Syndrome / immunology*
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / microbiology*
  • Pneumonia, Bacterial / pathology*
  • Quinolines / administration & dosage
  • Radiography, Thoracic / methods
  • Risk Assessment
  • Severity of Illness Index
  • Thienamycins / administration & dosage
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Thienamycins
  • Clindamycin
  • Meropenem
  • Moxifloxacin