FATAL BACILLUS-CEREUS MENINGOENCEPHALITIS IN AN ADULT WITH ACUTE MYELOGENOUS LEUKEMIA

Bacillus cereus, a ubiquitous, endospore-forming, aerobic gram-positiv e bacillus, is primarily associated with toxin-mediated food poisoning . Frequently, isolates of Bacillus species from clinical specimens are dismissed as contaminants. We report a rapidly fatal case of dissemin ated infection due to B cereus in a patient receiving induction chemot herapy for M0 acute leukemia. A short clinical syndrome of nausea and vomiting preceded neurologic symptoms. Autopsy showed extensive mening oencephalitis with subarachnoid hemorrhage and multiple liver abscesse s. Areas of necrosis were devoid of any inflammatory response consiste nt with a severely immunocompromised state. The organism was isolated from immediate premortem and autopsy blood specimens. This case illust rates the possibility and severity of true B cereus infections in immu nocompromised patients, the clinicopathologic features of which are as yet not well defined.