The spectrum of Bacillus bacteremias in heroin addicts

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Abstract
Bacillus bactermias occurred in 2 heroin addicts. The 1st pateint had 1 day of fever and chills after i.v. heroin use. Persistent [B.] cereus bacteremia consistent with endocarditis was documented and responded to 4 weeks of antibiotic therapy. The 2nd patient had non-cereus Bacillus species isolated from blood cultures 3 times over 8 days, each time after renewed heroin use. The patient remained well and the bacteremias cleared spontaneously. Because Bacillus spp. frequently contaminate heroin injection materials and because the Bacillus bacteremias were temporally associated with i.v. heroin use, Bacillus bacteremias in both patients probably eventuated from heroin abuse. These cases, in conjunction with 2 previously reported cases of Bacillus endocarditis in heroin addicts, suggest that herion addicts are at risk for developing Bacillus bacteremias, which may vary in severity from endocarditis to benign transient bacteremias.

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