[Bacillus cereus endocarditis and a probable cutaneous gateway]

Ann Dermatol Venereol. 2017 Jan;144(1):45-48. doi: 10.1016/j.annder.2016.09.045. Epub 2016 Oct 26.
[Article in French]

Abstract

Background: Bacillus cereus is a ubiquitous telluric organism. B. cereus endocarditis is a rare condition seen mostly in prosthetic heart valves and among intravenous drug users. We report a new case of a patient without risk factors and with a good clinical outcome not requiring valve replacement.

Case report: In October 2014, a 50-year-old woman was referred to the dermatology department of Lille University Hospital for lower-limb wounds developing 6 months earlier. She presented fever without clinical signs of infection, except for the lower-limbs wounds. Blood cultures revealed the presence of B. cereus. Transesophageal echocardiography was performed and revealed two foci of aortic valve vegetation with a diameter of 5mm. After bacterial sensitivity testing, rifampicin and levofloxacin treatment was given for six weeks, with complete remission. A skin graft was performed and good improvement was seen.

Discussion: Nineteen cases of B. cereus endocarditis have been described previously, only one of which was without risk factors. We described a case of complete remission after a 6-week course of antibiotics. Our case demonstrates that BC should not be considered as a blood culture contamination, and that treatment may be complex due to antibiotic resistance.

Keywords: Antibiothérapie; Antibiotics; Bacillus cereus; Endocardite; Endocarditis; Ulcères; Wounds.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bacillus cereus / isolation & purification*
  • Drug Therapy, Combination
  • Endocarditis / diagnosis
  • Endocarditis / drug therapy*
  • Endocarditis / microbiology*
  • Female
  • Humans
  • Leg Ulcer / complications*
  • Leg Ulcer / microbiology
  • Leg Ulcer / therapy
  • Levofloxacin / therapeutic use*
  • Middle Aged
  • Rifampin / therapeutic use*
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Levofloxacin
  • Rifampin