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      Recurrent Sepsis Due To Bacillus Licheniformis

      case-report

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          Abstract

          Bacillus licheniformis is recognized as a human pathogen causing infections, mainly in immunocompromised patients. We present a case of sepsis in an immunocompetent patient, caused by B. licheniformis. This case is of particular interest because the patient had no history of any immune deficiency and the disease did not respond to antibiotic treatment.

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          Most cited references11

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          Bacillus spp. among hospitalized patients with haematological malignancies: clinical features, epidemics and outcomes.

          Between April 2000 and May 2005, 350 bacteraemic episodes occurred among patients treated in our haematology unit. Two hundred and twenty-eight of these episodes were caused by Gram-positive pathogens, most commonly coagulase-negative staphylococci and Staphylococcus aureus. One hundred and twenty-two episodes were due to Gram-negative pathogens, with a predominance of Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa. Bacillus bacteraemias constituted 12 of these episodes occurring in 12 patients, and accounted for 3.4% of all bacteraemic episodes. Of the 12 strains evaluated, seven were Bacillus licheniformis, three were Bacillus cereus and two were Bacillus pumilus. Seven episodes presented with bloodstream infection, three with pneumonia, one with severe abdominal pain and deterioration of liver function, and one with a catheter-related bloodstream infection. B. licheniformis was isolated from five patients who had been hospitalized at the same time. This outbreak was related to non-sterile cotton wool used during skin disinfection. B. cereus and B. licheniformis isolates were susceptible to cefepime, carbapenems, aminoglycosides and vancomycin, but B. pumilus isolates were resistant to all antibiotics except for quinolones and vancomycin. Two deaths were observed. In conclusion, Bacillus spp. may cause serious infections, diagnostic and therapeutic dilemmas, and high morbidity and mortality in patients with haematological malignancies. Both B. cereus and B. licheniformis may be among the 'new' Gram-positive pathogens to cause serious infection in patients with neutropenia.
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            Bacillus licheniformis bacteremia: five cases associated with indwelling central venous catheters.

            Bacillus species are being more frequently recognized as pathogens in immunocompromised hosts or in patients with cancer and central venous catheters. Only nine cases of Bacillus licheniformis infection have been reported in the English-language literature since 1966. In a retrospective study we describe six patients and 17 episodes of B. licheniformis bacteremia over a 5-year span. All six patients had either a Hickman or a Broviac catheter in place for more than 3 months. Five of the six patients had multiple clinically significant episodes of bacteremia due to B. licheniformis. The six patients ranged in age from 4 years to 62 years. Two patients had leukemia or lymphoma and three patients had solid tumors, but only one patient was neutropenic. No deaths were related to B. licheniformis bacteremia. B. licheniformis should be considered as a potential pathogen in immunocompromised patients, especially when bacteremia is associated with the presence of long-term central venous catheters. Mortality due to B. licheniformis bacteremia is low, but recurrent bacteremia due to this organism causes significant morbidity and usually necessitates removal of the catheter.
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              Bacillus licheniformis prosthetic aortic valve endocarditis.

              A 73-year old man developed an acute prosthetic aortic valve dehiscence for which emergent operation was undertaken. The intraoperative evidence of an aortic annular disruption and of a subannular abscess led to the hypothesis that an endocarditis process was involved. The aortic valve was replaced with a stentless porcine bioprosthesis. Cultures taken intraoperatively from the aortic area had a pure growth of aerobic, spore-forming, gram-positive bacilli identified as Bacillus licheniformis. The patient responded to specific antibiotic therapy with no relapse at a 20-month follow-up. The potentiality of B. licheniformis as a pathogen should be reconsidered.
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                Author and article information

                Journal
                J Glob Infect Dis
                J Glob Infect Dis
                JGID
                Journal of Global Infectious Diseases
                Medknow Publications & Media Pvt Ltd (India )
                0974-777X
                0974-8245
                Jan-Mar 2012
                : 4
                : 1
                : 82-83
                Affiliations
                [1] Department of Clinical Microbiology, Plovdiv Medical University, Bulgarian Academy of Sciences, 26, Acad G. Bonchev str. Sofia 1113, Bulgaria
                [1 ] Department of Infectious Microbiology, Institute of Microbiology, Bulgarian Academy of Sciences, 26, Acad G. Bonchev str. Sofia 1113, Bulgaria
                Author notes
                Address for correspondence: Dr. Irina Haydushka, E-mail: ihaydouchka@ 123456yahoo.com
                Article
                JGID-4-82
                10.4103/0974-777X.93768
                3326966
                22529634
                25bd6789-deec-4aa3-9e52-99b2a850d09b
                Copyright: © Journal of Global Infectious Diseases

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case Report

                Infectious disease & Microbiology
                polyresistant strain,bacillus licheniformis,sepsis
                Infectious disease & Microbiology
                polyresistant strain, bacillus licheniformis, sepsis

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