Nakashima Marie, Osaki Masahide, Goto Tatsunori, Kagaya Yusuke, Kawashima Naomi, Morishita Takanobu, Ozawa Yukiyasu, Miyamura Koichi
Department of Hematology, Japanese Red Cross Nagoya First Hospital.
Rinsho Ketsueki. 2021;62(3):157-162. doi: 10.11406/rinketsu.62.157.
Bacillus cereus bacteremia is an infectious disease that may sometimes be fatal with a rapid clinical course. We performed a retrospective analysis on 12 patients with Bacillus cereus bacteremia recruited from January 2010 to March 2015. The primary diseases were acute leukemia (n=5), myelodysplastic syndromes (n=3), malignant lymphoma (n=3), and hemophagocytic syndrome (n=1). Neutrophil count at the onset of this bacteremia was less than 500 cells/µl in 9 patients. At the onset of bacteremia, we observed neurological symptoms (n=7), gastrointestinal symptoms (n=6), and findings suspected of infection at the venous catheter insertion site (n=6). Vancomycin was administered to all the patients; 10 patients showed improvement whereas 2 died early after allogeneic hematopoietic stem cell transplantation owing to bacteremia. Three patients had sequelae of central nervous system disorders. Neurological and gastrointestinal symptoms with fever may be predictors for this bacteremia, and early administration of appropriate antibacterial drugs may improve the prognosis. Future research should be aimed toward the identification of the clinical features of poor prognosis and establishment of remedies for Bacillus cereus bacteremia.
蜡样芽孢杆菌血症是一种传染病，有时可能会在快速的临床病程中导致死亡。我们对2010年1月至2015年3月招募的12例蜡样芽孢杆菌血症患者进行了回顾性分析。主要疾病为急性白血病（n = 5）、骨髓增生异常综合征（n = 3）、恶性淋巴瘤（n = 3）和噬血细胞综合征（n = 1）。9例患者在这种菌血症发作时中性粒细胞计数低于500个细胞/µl。在菌血症发作时，我们观察到神经症状（n = 7）、胃肠道症状（n = 6）以及静脉导管插入部位疑似感染的表现（n = 6）。所有患者均使用了万古霉素；10例患者病情好转，而2例在异基因造血干细胞移植后因菌血症早期死亡。3例患者有中枢神经系统疾病后遗症。伴有发热的神经和胃肠道症状可能是这种菌血症的预测指标，早期使用适当的抗菌药物可能会改善预后。未来的研究应致力于确定预后不良的临床特征并建立针对蜡样芽孢杆菌血症的治疗方法。
