Indiana University Infectious Diseases Fellowship
4 Dec,
10 tweets, 8 min read
#idboardreview 50 M Texan welder w/ diarrhea, cough, dyspnea x2d, presented to ED, sepsis and rapid progression to resp fail & death <8hrs after presentation. CT necrotizing pneumonia. +GPR #idtwitter #meded #idmeded 
#bacillus #cereus group bacteria are gram-positive facultative anaerobes, often toxin-producing, that are ubiquitous in the environment and reside naturally in soil and dust
#bacillus #cereus can also be found in food, and although infection typically causes illnesses characterized by diarrhea or vomiting, B. cereus can have other clinical manifestations (e.g., pulmonary, ocular, or cutaneous).
Among seven persons in the United States reported to be infected with #bacillus #cereus group bacteria containing anthrax toxin genes resulting in pneumonia since 1994, five patients died and two had critical illness with prolonged hospitalization and recovery
All persons with #bacillus #cereus #pneumonia were welders/metalworkers who had worked in Louisiana or Texas. In addition to 7 pneumonia cases, a cutaneous infection w/ B. cereus group bacteria containing anthrax toxin genes has been reported in a pt w/ anthrax eschar in Florida
Understanding the extent to which #Bacillus species other than B. anthracis carry anthrax toxin genes and whether their geographic range extends beyond the U.S. Gulf Coast states is limited.
Clinicians should consider #bacillus #cereus group bacteria in differential dx when treating welders/ metalworkers w/ severe, rapidly progressive pneumonia or other anthrax-like disease
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