<i>Bacillus cereus</i> Subacute Native Valve Infective Endocarditis and Its Multiple Complications

Nallarajah, Jemimah; Mujahieth, M. I.

doi:10.1155/2020/8826956

Cited by 8 publications

(5 citation statements)

References 13 publications

(12 reference statements)

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“…Our patient had glomerulonephritis believed to be secondary to his subacute endocarditis with renal injury and microscopic haematuria, which can be associated with subacute endocarditis. Similar findings have been described by Nallaraja et al in a patient with B. cereus endocarditis 1. In a biopsy-based study of 49 patients, over 80% of patients with infective endocarditis had a focal, segmental or diffuse proliferative glomerulonephritis.…”

Section: Discussionsupporting

confidence: 88%

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Polymicrobial native valve endocarditis due toBacillus cereusandCardiobacterium hominis

et al. 2021

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We present a case of polymicrobial subacute bacterial endocarditis and bacteremia with Bacillus cereus and Cardiobacterium hominis in a 72-year-old man with pre-existing mitral valve disease and prior mitral valve repair who presented with renal failure and glomerulonephritis. Bacillus is often a contaminant in blood cultures but has been rarely implicated in patients with invasive infections such as endocarditis. Intravenous drug use, prosthetic heart valves, valvular heart disease and venous catheters are the most frequently described risk factors for Bacillus bacteremia and endocarditis in the medical literature. Management is challenging as Bacillus is resistant to penicillin and cephalosporin antibiotics due to production of beta-lactamase. Polymicrobial endocarditis is uncommon and when it occurs typically involves Staphylococcal species. To our knowledge, this is the first reported case of polymicrobial endocarditis in which both Bacillus and a HACEK organism are implicated.

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Section: Discussionsupporting

confidence: 88%

“…Bacillus species are gram positive, aerobic, spore forming rods that are most commonly associated with a gastrointestinal illness 1. Injection drug users appear to be at particular risk for the development of invasive B. cereus infections such as endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

Polymicrobial native valve endocarditis due toBacillus cereusandCardiobacterium hominis

et al. 2021

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“…Often neonates, elderly or immunosuppressed patients are affected [ 347 , 348 ], but infections of immunocompetent persons are also known [ 349 ]. These include local, especially post-operative skin and wound infections [ 347 , 349 , 350 ], septicemia [ 350 , 351 , 352 , 353 , 354 , 355 , 356 , 357 , 358 , 359 , 360 ], meningitis [ 361 , 362 , 363 , 364 , 365 , 366 , 367 , 368 , 369 , 370 , 371 , 372 ], pneumonia (often by B. cereus strains exhibiting B. anthracis toxin genes) [ 373 , 374 , 375 , 376 , 377 , 378 ] and endocarditis [ 379 , 380 , 381 , 382 , 383 , 384 , 385 , 386 , 387 , 388 ]. Several studies focus on B. cereus -associated endophthalmitis, which occurs mainly following post-traumatic injuries and often leads to loss of vision or even of the eye in less than 48 h. Severe inflammation is caused by the concerted action of rapid bacterial replication, migration and toxin production […”

Section: The Diarrheal Enterotoxinsmentioning

confidence: 99%

The Food Poisoning Toxins of Bacillus cereus

Dietrich

Jeßberger

Ehling‐Schulz

et al. 2021

Toxins

165

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Bacillus cereus is a ubiquitous soil bacterium responsible for two types of food-associated gastrointestinal diseases. While the emetic type, a food intoxication, manifests in nausea and vomiting, food infections with enteropathogenic strains cause diarrhea and abdominal pain. Causative toxins are the cyclic dodecadepsipeptide cereulide, and the proteinaceous enterotoxins hemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe) and cytotoxin K (CytK), respectively. This review covers the current knowledge on distribution and genetic organization of the toxin genes, as well as mechanisms of enterotoxin gene regulation and toxin secretion. In this context, the exceptionally high variability of toxin production between single strains is highlighted. In addition, the mode of action of the pore-forming enterotoxins and their effect on target cells is described in detail. The main focus of this review are the two tripartite enterotoxin complexes Hbl and Nhe, but the latest findings on cereulide and CytK are also presented, as well as methods for toxin detection, and the contribution of further putative virulence factors to the diarrheal disease.

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“…In kidney biopsy, the most commonly identified pattern of injury was crescentic glomerulonephritis (51%), followed by proliferative glomerulonephritis (18%) (Table 3 ) [ 5 – 8 , 10 – 16 , 19 – 22 , 24 – 32 , 34 , 36 – 39 , 43 , 44 , 47 , 49 , 51 – 60 , 62 – 64 , 69 , 70 , 72 , 75 – 77 ]. Positivity of C1q and/or immunoglobulins, suggestive for immune complexes, was seen in 31% (16/49 cases), while a pauci-immune staining pattern with or without a trace of complement and/or immunoglobulins was reported in 37% (18/49 cases; Online resource 5) [ 5 – 7 , 10 – 16 , 20 , 22 , 24 – 32 , 34 , 36 , 38 , 39 , 44 , 49 , 51 , 54 , 56 – 58 , 60 , 62 , 63 , 69 , 70 , 72 , 75 – 77 ].…”

Section: Resultsmentioning

confidence: 99%

Antineutrophil cytoplasmic antibodies in infective endocarditis: a case report and systematic review of the literature

et al. 2022

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Infective endocarditis (IE) may be misdiagnosed as ANCA-associated vasculitis (AAV), especially when antineutrophil cytoplasmic antibodies (ANCA) are detected. Distinguishing IE from AAV is crucial to guide therapy. However, little is known about ANCA positivity in IE patients. We present a case report and systematic review of the literature on patients with ANCA-positive IE, aiming to provide a comprehensive overview of this entity and to aid clinicians in their decisions when encountering a similar case. A systematic review of papers on original cases of ANCA-positive IE without a previous diagnosis of AAV was conducted on PubMed in accordance with PRISMA-IPD guidelines. A predefined set of clinical, laboratory, and kidney biopsy findings was extracted for each patient and presented as a narrative and quantitative synthesis. A total of 74 reports describing 181 patients with ANCA-positive IE were included (a total of 182 cases including our own case). ANCA positivity was found in 18–43% of patients with IE. Patients usually presented with subacute IE (73%) and had positive cytoplasmic ANCA-staining or anti-proteinase-3 antibodies (79%). Kidney function was impaired in 72%; kidney biopsy findings were suggestive of immune complexes in 59%, while showing pauci-immune glomerulonephritis in 37%. All were treated with antibiotics; 39% of patients also received immunosuppressants. During follow-up, 69% of patients became ANCA-negative and no diagnosis of systemic vasculitis was reported. This study reviewed the largest series of patients with ANCA-positive IE thus far and shows the overlap in clinical manifestations between IE and AAV. We therefore emphasize that clinicians should be alert to the possibility of an underlying infection when treating a patient with suspected AAV, even when reassured by ANCA positivity. Key Points• This systematic review describes - to our knowledge - the largest series of patients with ANCA-positive infective endocarditis (IE) thus far (N=182), and shows a high degree of overlap in clinical manifestations between IE and ANCA-associated vasculitis (AAV).• ANCA positivity was found in 18-43% of patients with infective endocarditis. Of patients with ANCA-positive IE, the majority (79%) showed cytoplasmic ANCA-staining or anti-PR3-antibodies. We emphasize that clinicians should be alert to the possibility of an underlying infection when treating a patient with suspected AAV, even when reassured by ANCA positivity.• In patients with IE and ANCA-associated symptoms such as acute kidney injury, an important clinical challenge is the initiation of immunosuppressive therapy. All patients with data in this series received antibiotics; 39% also received immunosuppressive therapy. In many of these patients, ANCA-associated symptoms resolved or stabilized after infection was treated. ANCA titers became negative in 69% , and a diagnosis of AAV was made in none of the cases. We therefore recommend that (empiric) antibiotic treatment remains the therapeutic cornerstone for ANCA-positive IE patients, while a watchful wait-and-see approach with respect to immunosuppression is advised.

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Bacillus cereus Subacute Native Valve Infective Endocarditis and Its Multiple Complications

Cited by 8 publications

References 13 publications

Polymicrobial native valve endocarditis due toBacillus cereusandCardiobacterium hominis

Polymicrobial native valve endocarditis due toBacillus cereusandCardiobacterium hominis

The Food Poisoning Toxins of Bacillus cereus

Antineutrophil cytoplasmic antibodies in infective endocarditis: a case report and systematic review of the literature

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