Journal of Shanghai Jiao Tong University (Medical Science) >

2025 , Vol. 45 >Issue 8: 1074 - 1078

DOI: https://doi.org/10.3969/j.issn.1674-8115.2025.08.016

Case report

Case report of severe aplastic anemia complicated by multiple Bacillus cereus infections

  • ZHOU Huiru ,
  • ZHANG Liqin ,
  • ZHANG Xiaoxing ,
  • SUN Zhijiang
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  • Department of Intensive Care Unit 2, Gansu Provincial Hospital, Lanzhou 730000, China
ZHANG Liqin, E-mail: zhangliqin1984@163.com.

Received date: 2025-03-06

  Accepted date: 2025-04-28

  Online published: 2025-08-18

Supported by

Gansu Medical Laboratory Clinical Medicine Research Center(21JR7RA676);Lanzhou City Science and Technology Plan Projects(2023-2-100);Gansu Provincial Hospital Research Fund(24GSSYB-9)

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Abstract

Patients with severe aplastic anemia (SAA) often present with neutropenia, and are particularly susceptible to infections, especially following immunosuppressive therapy. Bacillus cereus is a ubiquitous, opportunistic pathogen capable of colonizing healthy individuals and causing infections through various routes. Neutropenia is a common feature in many hematologic disorders, placing affected patients at higher risk for Bacillus cereus infections. This report describes a rare case of Bacillus cereus bacteremia with multiple abscesses in a patient with SAA during the neutropenic phase following immunosuppressive therapy. Given the rarity of such presentations, relevant literature was reviewed and the diagnostic and treatment process was analyzed in detail, with the aim of providing clinical insights and improving the management of similar cases.

Key words： aplastic anemia; Bacillus cereus; bacteremia; abscess

Cite this article

ZHOU Huiru , ZHANG Liqin , ZHANG Xiaoxing , SUN Zhijiang . Case report of severe aplastic anemia complicated by multiple Bacillus cereus infections[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025 , 45(8) : 1074 -1078 . DOI: 10.3969/j.issn.1674-8115.2025.08.016

References

[1] 陈琼, 方杰, 魏强华. 系统性红斑狼疮合并纯红细胞再生障碍性贫血1例报道及文献复习[J]. 上海交通大学学报(医学版), 2024, 44(2): 278-286.
  CHEN Q, FANG J, WEI Q H. Systemic lupus erythematosus complicated with pure red cell aplasia: a case report and literature review[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(2): 278-286.
[2] DEZERN A E, CHURPEK J E. Approach to the diagnosis of aplastic anemia[J]. Blood Adv, 2021, 5(12): 2660-2671.
[3] DUAN S G, YU Y, GUO Y C, et al. Epidemiological evaluation of Bacillus cereus-induced foodborne outbreaks: China, 2010?2020[J]. China CDC Wkly, 2023, 5(33): 737-741.
[4] SCOPPAPIETRA L, AUDINO A, RICCIARDELLI G, et al. A fatal rhabdomyolysis with the presence of Bacillus cereus on blood culture: description of a clinical case[J]. Microbiol Med, 2024, 39(1): 12419.
[5] SHIMADA T, ISHIKAWA K, KAWAI F, et al. Risk factors associated with infection-related mortality of Bacillus cereus bacteremia in hematologic disorders[J]. Int J Hematol, 2023, 118(6): 726-730.
[6] LITTLE J S, COUGHLIN C, HSIEH C, et al. Neuroinvasive Bacillus cereus infection in immunocompromised hosts: Epidemiologic investigation of 5 patients with acute myeloid leukemia[J]. Open Forum Infect Dis, 2024, 11(3): ofae048.
[7] HUANG L F, LI L, JIA J S, et al. Frontline therapy options for adults with newly diagnosed severe aplastic anemia: intensive immunosuppressive therapy plus eltrombopag or matched sibling donor hematopoietic stem cell transplantation?[J]. Transplant Cell Ther, 2022, 28(9): 586.e1-586.e7.
[8] LI X L, SHANGGUAN X H, WANG H, et al. Comparison of efficacy of eltrombopag combined with immunosuppression in the treatment of severe aplastic anemia and very severe aplastic anemia: real-world data and evidence[J]. Ann Hematol, 2024, 103(9): 3483-3491.
[9] SUN S, XU Z Y, HU H J, et al. The Bacillus cereus toxin alveolysin disrupts the intestinal epithelial barrier by inducing microtubule disorganization through CFAP100[J]. Sci Signal, 2023, 16(785): eade8111.
[10] ENOSI TUIPULOTU D, MATHUR A, NGO C, et al. Bacillus cereus: epidemiology, virulence factors, and host-pathogen interactions[J]. Trends Microbiol, 2021, 29(5): 458-471.
[11] OKUTANI A, OKUGAWA S, FUJIMOTO F, et al. Genetic diversity and virulence of Bacillus cereus group isolates from bloodstream infections[J]. Microbiol Spectr, 2025, 13(3): e0240724.
[12] 毛原飞, 游建华, 张莉娜, 等. 恶性血液病化疗后粒细胞缺乏期医院感染危险因素的分析[J]. 上海交通大学学报(医学版),2014, 34(1): 60-64.
  MAO Y F, YOU J H, ZHANG L N, et al. Risk factors for nosocomial infection in agranulocytosis patients after chemotherapy to hematological malignancy[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2014, 34(1): 60-64.
[13] HIDALGO A, LIBBY P, SOEHNLEIN O, et al. Neutrophil extracellular traps: from physiology to pathology[J]. Cardiovasc Res, 2022, 118(13): 2737-2753.
[14] MURSALIN M H, LIVINGSTON E T, CALLEGAN M C. The Cereus matter of Bacillus endophthalmitis[J]. Exp Eye Res, 2020, 193: 107959.
[15] MEI F, LIN J Q, LIU M L, et al. Posttraumatic Bacillus cereus endophthalmitis: clinical characteristics and antibiotic susceptibilities[J]. J Ophthalmol, 2021, 2021: 6634179.
[16] BOUSTANY A, RAMAHI N, HINDY J R, et al. Persistent Bacillus cereus bacteremia in an immunocompetent patient with a history of polysubstance abuse[J]. Cureus, 2023, 15(1): e33650.
[17] 金磊, 徐文彬, 叶晨静, 等. 泊沙康唑对血液恶性肿瘤化疗患者的预防性抗真菌作用[J]. 上海交通大学学报(医学版), 2022, 42(6): 792-796.
  JIN L, XU W B, YE C J, et al. Prophylactic antifungal effect of posaconazole on patients with hematological malignant tumor undergoing chemotherapy[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(6): 792-796.
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