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Pediatrics. 2010 Apr;125(4):e951-5. doi: 10.1542/peds.2009-2319. Epub 2010 Mar 1.

Rapid detoxification of cereulide in Bacillus cereus food poisoning.

Author information

1
Kitano Hospital, Department of Pediatrics, 2-4-20, Ohgimachi, Kita-ku, Osaka City, Osaka, Japan. mi-shiota@kitano-hp.or.jp

Abstract

Bacillus cereus is recognized as a major pathogenic bacterium that causes food poisoning and produces gastrointestinal diseases of 2 types: emetic and diarrheal. The emetic type, which is often linked to pasta and rice, arises from a preformed toxin, cereulide, in food. Rapid and accurate diagnostic methods for this emetic toxin are important but are limited. Here we describe 3 patients with B cereus food poisoning in which cereulide was detected and measured sequentially. Three family members began to vomit frequently 30 minutes after consuming reheated fried rice. After 6 hours, a 1-year-old brother died of acute encephalopathy. A 2-year-old sister who presented with unconsciousness recovered rapidly after plasma exchange and subsequent hemodialysis. Their mother recovered soon by fluid therapy. From leftover fried rice and the children's stomach contents, B cereus was isolated. Serum cereulide was detected in both children; it decreased to an undetected level in the sister. These cases highlight the importance of measuring the value of cereulide, which would reflect the severity of B cereus emetic food poisoning. The cases also suggest the possible role of blood-purification therapy in severe cases.

PMID:
20194285
DOI:
10.1542/peds.2009-2319
[Indexed for MEDLINE]

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