{"title":"Diagnostic imaging of Bacillus cereus brain infection in newborns.","authors":"Benjamin Feferman, Valentina Fernandez, Elsa Tavernier, Julie Fuseau, Catherine Sembély-Taveau, Ronan Boennec, Agathe Cremades, Zoha Maakaroun-Vermesse, Christelle Follet, Delphine Mitanchez, Philippe Lanotte, Cécile Le Brun, Laurent Brunereau, Laurent Mereghetti, Baptiste Morel","doi":"10.1007/s00247-025-06169-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cerebral infection with the opportunistic pathogen Bacillus cereus can lead to severe lesions, especially in premature newborns. Early diagnosis would be highly beneficial. The aim of this study was to describe the imaging findings associated with B. cereus infections.</p><p><strong>Materials and methods: </strong>We included all newborns with a positive B. cereus blood culture and transfontanellar ultrasound between 2012 and 2022 at the Tours University Hospital. Imaging was assessed by both a junior and a senior radiologist to differentiate between hemorrhages, leukomalacia, and lesions attributed to B. cereus.</p><p><strong>Results: </strong>Nineteen patients were enrolled (12 girls), of whom 18 were premature. Three patients did not survive. Six patients had normal ultrasound and brain magnetic resonance imaging (MRI) scans. Thirteen patients had ultrasound-detected lesions: 7 hemorrhages, 1 case of leukomalacia, 1 focal ischemic lesion, and 5 lesions attributed to B. cereus. The B. cereus lesions appeared as irregular (5/5), bilateral (4/5), asymmetric (5/5), and hyperechoic patches in the subcortical white matter. They were extensive, asynchronous, and rapidly progressive over a few days (central necrosis with peripheral enhancement, referred to as the \"bear scratch sign\"), while respecting the cortex and basal ganglia.</p><p><strong>Conclusion: </strong>The presence of rapidly evolving white matter lesions should raise suspicion of B. cereus infection in newborns' brains. Imaging plays a crucial role in estimating the progression of this pathology.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00247-025-06169-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
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Abstract
Background: Cerebral infection with the opportunistic pathogen Bacillus cereus can lead to severe lesions, especially in premature newborns. Early diagnosis would be highly beneficial. The aim of this study was to describe the imaging findings associated with B. cereus infections.
Materials and methods: We included all newborns with a positive B. cereus blood culture and transfontanellar ultrasound between 2012 and 2022 at the Tours University Hospital. Imaging was assessed by both a junior and a senior radiologist to differentiate between hemorrhages, leukomalacia, and lesions attributed to B. cereus.
Results: Nineteen patients were enrolled (12 girls), of whom 18 were premature. Three patients did not survive. Six patients had normal ultrasound and brain magnetic resonance imaging (MRI) scans. Thirteen patients had ultrasound-detected lesions: 7 hemorrhages, 1 case of leukomalacia, 1 focal ischemic lesion, and 5 lesions attributed to B. cereus. The B. cereus lesions appeared as irregular (5/5), bilateral (4/5), asymmetric (5/5), and hyperechoic patches in the subcortical white matter. They were extensive, asynchronous, and rapidly progressive over a few days (central necrosis with peripheral enhancement, referred to as the "bear scratch sign"), while respecting the cortex and basal ganglia.
Conclusion: The presence of rapidly evolving white matter lesions should raise suspicion of B. cereus infection in newborns' brains. Imaging plays a crucial role in estimating the progression of this pathology.
期刊介绍：
Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology
Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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