Department of Pathology and Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA.
Department of Pathology and Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA.
Diagn Microbiol Infect Dis. 2021 Dec;101(4):115534. doi: 10.1016/j.diagmicrobio.2021.115534. Epub 2021 Sep 10.
Bloodstream infection with Bacillus cereus/thuringiensis can be life threatening, particularly in patients who are severely immunocompromised. In this report we describe a case that progressed from asymptomatic to fatal over approximately 5 hours despite extensive resuscitation efforts. We identify the pathogen and assemble its genome, in which we find genes for toxins that may have contributed to the precipitous demise. In the context of this and other cases we discuss the possible indication for rapid appropriate antibiotic administration and potentially antitoxin treatment or toxin removal in fulminant illness in immunocompromised patients.
血液感染蜡样芽胞杆菌/苏云金芽孢杆菌可能危及生命，尤其是在严重免疫功能低下的患者中。在本报告中，我们描述了一例患者，尽管进行了广泛的复苏努力，但从无症状到致命的进展大约在 5 小时内发生。我们确定了病原体并组装了其基因组，在其中发现了可能导致病情迅速恶化的毒素基因。在本病例和其他病例的背景下，我们讨论了在免疫功能低下患者的暴发性疾病中快速给予适当抗生素和潜在抗毒素治疗或毒素清除的可能指征。
