Bacillus cereus is a Gram-positive aerobic or facultatively anaerobic spore
-forming rod, which usually causes food poisoning. Its recognition as a pat
hogen in neonates has increased over the past two decades. The clinical cou
rse of a neonate (gestation 24 weeks) with B. cereus infection refractory t
o therapy is described. Death occurred after withdrawal of support followin
g persistently positive blood and bone marrow cultures despite therapy with
vancomycin, gentamicin, imipenum, clindamycin, ciprofloxacillin, immunoglo
bulin and granulocyte colony stimulating factor over a period of 49 days. N
o obvious focus of sepsis was identified. Contamination from the environmen
t into the hospital and clinics occurs because of the ubiquitous presence o
f B. cereus. Combination therapy with vancomycin and gentamycin is appropri
ate for meningitis/severe systemic infections related to most bacillus spec
ies. The significance of repeated isolation of B. cereus in neonates with c
ompromised host defences is emphasised.