Tschiedel Eva, Rath Peter-Michael, Steinmann Jörg, Becker Heinz, Dietrich Rudolf, Paul Andreas, Felderhoff-Müser Ursula, Dohna-Schwake Christian
Department of Pediatrics 1, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Pediatr Transplant. 2015 Feb;19(1):E11-4. doi: 10.1111/petr.12378. Epub 2014 Oct 17.
Bacillus cereus is a spore-forming, gram-positive bacterium that causes food poisoning presenting with either emesis or diarrhea. Diarrhea is caused by proteinaceous enterotoxin complexes, mainly hemolysin BL, non-hemolytic enterotoxin (NHE), and cytotoxin K. In contrast, emesis is caused by the ingestion of the depsipeptide toxin cereulide, which is produced in B. cereus contaminated food, particularly in pasta or rice. In general, the illness is mild and self-limiting. However, due to cereulide intoxication, nine severe cases with rhabdomyolysis and/or liver failure, five of them lethal, are reported in literature. Here we report the first case of life-threatening liver failure and severe rhabdomyolysis in this context that could not be survived without emergency hepatectomy and consecutive liver transplantation.
蜡样芽孢杆菌是一种形成芽孢的革兰氏阳性细菌，可引起以呕吐或腹泻为表现的食物中毒。腹泻由蛋白质性肠毒素复合物引起，主要是溶血素BL、非溶血肠毒素（NHE）和细胞毒素K。相比之下，呕吐是由于摄入了在被蜡样芽孢杆菌污染的食物中产生的环肽毒素蜡样毒素，尤其是在面食或米饭中。一般来说，这种疾病症状较轻且具有自限性。然而，据文献报道，由于蜡样毒素中毒，出现了9例伴有横纹肌溶解和/或肝功能衰竭的严重病例，其中5例死亡。在此，我们报告了首例在这种情况下出现的危及生命的肝功能衰竭和严重横纹肌溶解病例，若不进行紧急肝切除术和后续肝移植则无法存活。
