Bacillus cereus food poisoning
The pathogenicity of B. cereus is related to its ability to form biofilms and spores that confer resistance against standard cleaning procedures, as well as the production of a variety of tissue-destructive enzymes and toxins.
The foodborne disease caused by B. cereus does not show a predilection for a particular population group. Nongastrointestinal disease is most commonly reported among neonates, intravenous drug abusers, patients sustaining traumatic or surgical wounds, and those with indwelling catheters.
Less frequently, B. cereus can cause bloodstream and catheter-related infections, respiratory infections, severe invasive central nervous system (CNS) disease (meningitis and brain abscesses in immunosuppressed patients with hematological malignancies), endophthalmitis, and gas gangrene-like infections.
A05.4 – Foodborne Bacillus cereus intoxication
19894004 – Food poisoning due to Bacillus cereus
Differential Diagnosis & Pitfalls
- Staphylococcus aureus food poisoning resembles the emetic syndrome caused by B. cereus but it has a longer incubation period.
- Clostridium perfringens food poisoning is similar to the diarrheal syndrome.
- Campylobacter spp., Shiga toxin-producing Escherichia coli (STEC), Shigella spp., and Salmonella spp., with incubation periods of 1 day to 1 week.
- Bacteremia and endocarditis – Differentiating true bacteremia from contamination due to Bacillus spp. can be difficult. True bacteremia is likely present if Bacillus spp. is isolated from both bottles of a single set of blood cultures or isolated repeatedly from multiple blood cultures.
- Necrotizing soft tissue infection due to B. cereus may resemble infection by Clostridium spp.
- Pneumonia is similar to inhalational anthrax.