Kitano Hospital, Department of Pediatrics, 2-4-20, Ohgimachi, Kita-ku, Osaka City, Osaka, Japan.
Pediatrics. 2010 Apr;125(4):e951-5. doi: 10.1542/peds.2009-2319. Epub 2010 Mar 1.
Bacillus cereus is recognized as a major pathogenic bacterium that causes food poisoning and produces gastrointestinal diseases of 2 types: emetic and diarrheal. The emetic type, which is often linked to pasta and rice, arises from a preformed toxin, cereulide, in food. Rapid and accurate diagnostic methods for this emetic toxin are important but are limited. Here we describe 3 patients with B cereus food poisoning in which cereulide was detected and measured sequentially. Three family members began to vomit frequently 30 minutes after consuming reheated fried rice. After 6 hours, a 1-year-old brother died of acute encephalopathy. A 2-year-old sister who presented with unconsciousness recovered rapidly after plasma exchange and subsequent hemodialysis. Their mother recovered soon by fluid therapy. From leftover fried rice and the children's stomach contents, B cereus was isolated. Serum cereulide was detected in both children; it decreased to an undetected level in the sister. These cases highlight the importance of measuring the value of cereulide, which would reflect the severity of B cereus emetic food poisoning. The cases also suggest the possible role of blood-purification therapy in severe cases.
蜡样芽胞杆菌被认为是一种主要的致病菌，可导致食物中毒，并产生 2 种类型的胃肠道疾病：呕吐型和腹泻型。呕吐型食物中毒通常与意大利面和米饭有关，是由食物中预先形成的呕吐毒素——cereulide 引起的。然而，这种呕吐毒素的快速、准确诊断方法很重要，但却受到限制。在这里，我们描述了 3 例蜡样芽胞杆菌食物中毒患者，他们的呕吐毒素被依次检测和测量。3 名家庭成员在食用重新加热的炒饭 30 分钟后开始频繁呕吐。6 小时后，1 岁的弟弟因急性脑病死亡。2 岁的妹妹出现昏迷，经血浆置换和随后的血液透析后迅速恢复。他们的母亲通过补液治疗很快康复。从剩余的炒饭和孩子们的胃内容物中分离出蜡样芽胞杆菌。两个孩子的血清中均检测到 cereulide；妹妹的 cereulide 降至无法检测的水平。这些病例强调了测量 cereulide 值的重要性，这可以反映出蜡样芽胞杆菌呕吐型食物中毒的严重程度。这些病例还提示在严重病例中可能需要血液净化治疗。
