Persistent Bacillus licheniformis bacteremia associated with an intentional injection of organic drain cleaner

In recent years manufacturers have developed several products containing sa prophytic bacteria, previously believed to be of minimal pathogenicity. We describe the first case of persistent Bacillus licheniformis bacteremia occ urring after intentional injection of a consumer product that includes B. l icheniformis spores. We postulate that these spores remained in the tissue, unaffected by antimicrobials, ultimately necessitating soft-tissue debride ment of the area surrounding the injection site. On the basis of this case and a review of the literature, we submit that some consumer products conta in bacteria with demonstrated pathogenicity. Manufacturers should study the se bacteria in detail in order to rapidly provide information such as bacte riologic data and antimicrobial susceptibility data to clinicians.