Bacillus cereus bacteraemia complicated by a brain abscess in a pre-term neonate

Bacillus cereus is a common laboratory and environmental contaminant. Reports of severe infections are mainly limited to immunocompromised individuals. In reported cases, the time interval between bacteraemia and neuro-invasion appears to be very short, highlighting the importance of rapid and definitive identification and susceptibility testing of invasive B. cereus. We report a case of a neonatal B. cereus bacteraemia complicated by a brain abscess from a neonatal intensive care unit. The neonate presented with bradycardia and desaturations with increased oxygen requirements. Initial blood culture detected B. cereus but was considered a contaminant. Repeated culturing of the Gram-positive rod was subsequently considered to be significant. Initial ultrasound head scans revealed echogenicity in the right posterior deep white matter. A large central cavity (5 mm diameter) could eventually be observed. The brain abscess resolved after surgical drainage and an extensive 6 weeks of antimicrobial therapy. This case study describes a rare event that illustrates the importance of rapid identification and susceptibility testing of invasive B. cereus isolates from immunocompromised patients.