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November 9, 1979

Bacillus cereus: Not a Contaminant

Author Affiliations

Emory University Hospital Atlanta

JAMA. 1979;242(19):2069. doi:10.1001/jama.1979.03300190011006

To the Editor.—  Coincident with the publication of the article by Tuazon et al (241:1137, 1979), I participated in the care of a patient with pneumonia and empyema due to Bacillus cereus. The case is described here to emphasize that this Gram-positive bacillus should not be dismissed as a bacteriologic contaminant of clinical specimens. Also, apparently appropriate antimicrobial therapy as determined by disk sensitivity may not be adequate in predicting response.

Report of a Case.—  A 50-year-old man with chronic active hepatitis and cirrhosis was hospitalized with two days of fever, dyspnea, and left-sided pleuritic chest pain. One month previously, he had been hospitalized with chills, hemoptysis, and bilateral lower lobe pulmonary infiltrates, thought to be consistent with pulmonary emboli. An episode of gastroenteritis followed.On admission, temperature was 38.6 °C; respirations were 35/min. Spider angioma, palmar erythema, and ascites were present. Examination of the chest disclosed rales, rhonchi,