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Bacillus cereus poisoning

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Version Jan 2023

A common cause of Rapid onset of vomiting within hours of food due to pre-formed enterotoxins seen in exams - eaten Fried rice, Vomits then diarrhoea then better

About

An important cause of food poisoning for exams

Source

Frequently contaminate clinical environments, biotechnological processes, and food production
Found in fried rice left at room temperature and vegetables,
Less commonly in cakes, pastas and sauces

Characteristics

Aerobic. Gram-positive spore formers - spores are resistant to boiling
Produces emetic enterotoxins when rice is fried and badly stored
Two toxins first causes emetic syndrome and other a diarrheal syndrome (enterotoxin)
Due to the fact that spores of B. cereus resist the heating process, and germinate and multiply during storage of the leftover food at room temperature

Clinical

Vomiting within 5 hours and then a diarrhoeal illnesss
Resolution in 24 hours and return to normal
Very Rarely systemic with pneumonia and endocarditis

Management

Self limiting. Conservative management only. Oral rehydration
Notifiable if source is a food vendor

References

Bacillus cereus at CDC

Rapid onset of vomiting within hours of food consumption occurs after the ingestion of the pre-formed enterotoxins of B. cereus. Fried rice or sauces are frequent sources, and enterotoxin is formed during storage. Between 1 and 4 hrs after ingestion, brisk vomiting and some diarrhoea occur, with rapid resolution within 24 hrs. If viable organisms are ingested, the toxin is produced within the gut, leading to a longer incubation period of 12–24 hrs and watery diarrhoea with abdominal cramps. The disease is self-limiting. Management simply consists of fluid replacement and public health notification.

PLEASE NOTE LEGAL ADVICE: The contents are under continuing development and improvements and may contain errors of omission or fact. The official launch will be at the end of 2018. Feedback vital and always welcome at drokane at gmail.com. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice. It is only for educational purposes. Please adhere to your local protocols. If you are unwell please seek healthcare advice from your doctor. This does not replace senior or specialist advice. If you do not accept this then please do not use the website. If you need medical advice, please consult a doctor or other appropriate medical professional. If you are a medical professional and you need advice then speak to your senior or colleagues.

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