II. Epidemiology
- Incidence (U.S.): 63,000 cases with 20 hospitalizations and 0 deaths per year
III. Pathophysiology
- Bacillus Cereus is an aerobic, motile, Gram Positive Spore-Forming Rod
- Spores contaminate foods and are resistant to intial cooking
- Spores may be inactivated by high Temperatures or refrigeration
- Spores germinate in food and release Enterotoxins
-
Enterotoxins are pre-formed toxins exerting disease on ingestion (without need of further B. cereus reproduction)
- Heat-Labile Toxin
- Results in Nausea, Abdominal Pain and Diarrhea lasting 12 to 24 hours
- Similar to C. Perfringens Enterotoxin, Cholera Enterotoxin, or E. coli labile toxin
- Heat-Stable Toxin
- Results in severe Nausea, Vomiting and more mild Diarrhea shortly after food ingestion
- Similar to Staphylococcus AureusFood Poisoning
- Heat-Labile Toxin
IV. Causes: Exposures
- Meats, stews and gravy
- Hamburger (45-63% infected)
- Luncheon Meats (15% infected)
- Rice
- Raw rice (100% infected)
- Fried rice
- Miscellaneous
- Vanilla sauce
V. Findings
VI. Management
- Supportive Care
-
Antibiotics are not indicated
- Illness is caused by pre-formed toxin
VII. Resources
- Bacillus Cereus (StatPearls)
VIII. References
- Gladwin, Trattler and Mahan (2014) Clinical Microbiology, Medmaster, Fl, p. 49-50
- Dietrich (2021) Toxins 13(2):98 +PMID: 33525722 [PubMed]
- Bottone (2010) Clin Microbiol Rev 23(2):382-98 +PMID: 20375358 [PubMed]