Liver failure after Bacillus cereus food poisoning,an underrecognized entity:A case report  

作　　者：Olivier Chatelanat Mikaël de Lorenzi-Tognon Laurent Spahr Abdessalam Cherkaoui Roger Stephan Marie Ongaro Laurent Kaiser Nicolas Goossens 

机构地区：[1]Department of Gastroenterology and Hepatology,Geneva University Hospitals,Geneva 1205,Switzerland [2]Department of Infectious Diseases,Geneva University Hospitals,Geneva 1205,Switzerland [3]Department of Genetics and Laboratory Medicine,Geneva University Hospitals,Geneva 1205,Switzerland [4]Institute for Food Safety and Hygiene,University of Zürich,Zurich 8057,Switzerland

出　　处：《World Journal of Hepatology》2024年第11期1339-1347,共9页世界肝病学杂志（英文）

摘　　要：BACKGROUND Bacillus cereus(B.cereus)is known to cause 2 types of foodborne diseases;the diarrheal and emetic syndromes.They are largely underreported due to their usually self-limiting course.Rare and sometimes fatal cases of liver failure,pulmonary hemorrhage and cerebral oedema have been reported mainly in children and young adults.We present here a case of liver failure associated with B.cereus food poisoning in a middle-aged patient.CASE SUMMARY A 48-year-old female patient presented to the emergency department for emesis,diarrhea,chills without fever,asthenia and diffuse abdominal cramps that started less than 30 minutes after eating a rice salad.Her past medical history was relevant for cholecystectomy and a cured Hashimoto’s disease.She did not take any medication,drugs and declared a consumption of one glass of wine per week.In the emergency department,she was treated with acetaminophen,metoclopramide,ondansetron,and an intravenous normal saline infusion.Blood gas analysis revealed a metabolic acidosis with hyperlactatemia,coagulation revealed a low prothrombin activity[32%;normal values(N):70-140]and a low Factor V activity(15%;N:>70).Transaminases were elevated with hyperbilirubinemia,elevated lipase and rhabdomyolysis.N-acetylcysteine treatment was introduced.Abdominal echography revealed no signs of chronic hepatopathy or hepatomegaly.Day after the admission,psychomotor activity improved,transaminases and lipase started decreasing.Rhabdomyolysis gradually worsened to peak on day 3.Screening tests for liver disease were negative for viral and autoimmune cause of liver failure.Stools cultures were positive for colonies of the B.cereus group which were also identified in the rice salad samples processed whereas blood cultures were negative.The patient’s condition improved gradually including her liver function parameters and psychomotor activity which allowed her discharged home on day 9.CONCLUSION We describe a rare case of hepatocellular dysfunction due to a foodborne B.cereus intoxication in an ad

关 键 词：Liver failure Foodborne intoxication Bacillus cereus Toxin cereulide Emetic syndrome ACETAMINOPHEN Case report 

分 类 号：R575.3[医药卫生—消化系统]