CLINICAL INFECTIOUS DISEASE ARTICLES Osteomyelitis Due to Bacillus cereus in an Adolescent: Case Report and Review

Non-anthracis Bacillus species associated with clinical infections are usually dismissed as con-taminants or nonpathogens. As opportunists, however, Bacillus organisms can cause significant systemic infections including bacteremia, endophthalmitis, and pneumonia. Osteomyelitis with non-anthracis Bacillus organisms has been described in adults, although to our knowledge it has been described only once in a child. We report a case of chronic osteomyelitis due to Staphylococ-cusaureus and superinfection with Bacillus cereus in a 13-year-old adolescent. A Bacillus isolate should be considered a true pathogen in children with chronic osteomyelitis who have a poor clinical response to antistaphylococcal therapy. Bacillus organisms are aerobic, gram-positive, sporulating rods that are widely distributed in the soil, air, and water; the most infamous and lethal species of this genus is Bacillus anthracis. Less appreciated for their clinical significance are the non-anthracis Bacillus species, commonly dismissed as microbiological contaminants or nonpathogens since they rarely cause invasive disease in humans [1-5]. The mos