Bacillus cereus endocarditis and a probable cutaneous gateway

• Published in: Annales de dermatologie et de vénéréologie 2017-01, Vol.144 (1), p.45-48
• Main Authors: Soudet, S, Becquart, C, Dezoteux, F, Faure, K, Staumont-Salle, D, Delaporte, E
• Format: Article
• Language: fre
• Subjects: Anti-Bacterial Agents - therapeutic use; Bacillus cereus - isolation & purification; Drug Therapy, Combination; Endocarditis - diagnosis; Endocarditis - drug therapy; Endocarditis - microbiology; Female; Humans; Leg Ulcer - complications; Leg Ulcer - microbiology; Leg Ulcer - therapy; Levofloxacin - therapeutic use; Middle Aged; Rifampin - therapeutic use; Risk Factors; Time Factors; Treatment Outcome
• ISSN: 0151-9638
• DOI: 10.1016/j.annder.2016.09.045

Bacillus cereus is a ubiquitous telluric organism. B. cereus endocarditis is a rare condition seen mostly in prosthetic heart valves and among intravenous drug users. We report a new case of a patient without risk factors and with a good clinical outcome not requiring valve replacement. In October 2014, a 50-year-old woman was referred to the dermatology department of Lille University Hospital for lower-limb wounds developing 6 months earlier. She presented fever without clinical signs of infection, except for the lower-limbs wounds. Blood cultures revealed the presence of B. cereus. Transesophageal echocardiography was performed and revealed two foci of aortic valve vegetation with a diameter of 5mm. After bacterial sensitivity testing, rifampicin and levofloxacin treatment was given for six weeks, with complete remission. A skin graft was performed and good improvement was seen. Nineteen cases of B. cereus endocarditis have been described previously, only one of which was without risk factors. We described a case of complete remission after a 6-week course of antibiotics. Our case demonstrates that BC should not be considered as a blood culture contamination, and that treatment may be complex due to antibiotic resistance.