Fulminant multi-organ failure associated with cereulide-producing Bacillus cereus after consumption of improperly stored rice.
Lasse Schopmeyer, Maaike Biewenga, Menno van der Voort et al.
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Case in brief
A previously healthy male in his 20s presented with generalized seizures and severe hypoglycemia after eating improperly stored reheated rice. Laboratory tests indicated acute liver failure, acute kidney injury, and lactic acidosis, leading to multi-organ failure. With intensive supportive care, he improved and avoided liver transplantation, ultimately achieving full neurological recovery. Toxicological analysis confirmed high levels of cereulide, a toxin from Bacillus cereus.
What made this case unusual
The case highlights the severe consequences of cereulide intoxication, leading to rapid multi-organ failure, which is uncommon in foodborne illnesses.
Diagnostic / clinical pearl
Clinicians should consider cereulide intoxication in patients with acute multi-organ failure following the consumption of improperly stored starchy foods.
Why it matters
This case underscores the importance of safe food storage practices and the need for healthcare professionals to recognize the potential severity of cereulide-related illnesses.