Bacillus cereus infection of the penis: an unusual infection

Abstract

Background: Bacillus cereus (B. cereus) is a Gram positive, rod shaped, motile organism, found in the environment and may exist in contaminated food sources such as reheated rice, vegetables and may led to gastro-intestinal symptoms after ingestion including diarrhea, nausea, and vomiting due to enterotoxigenic and emetic toxins. Non-Gastro-intestinal infections of Bacillus Cereus have been reported in the literature which include cutaneous and non-cutaneous infections in immunocompetent and immunocompromised individuals. Case presentation: A 38-year-old man presented with a one-week history of penile swelling and redness that started after an episode of severe diarrhea and vomiting which soiled his genital region few hours after vigorous intercourse with his wife. This has led to infection of the penile skin by an unusual organism: Bacillus (B.) cereus. Patient was treated using Fucidic acid ointment applications for 2 weeks achieving complete recovery. Clinical discussion: The recovery of B. cereus from the penile infection in our patient reveals the first case of such unusual infection, though this pathogen has been reported to cause a wide range of non-GI tract infections which include bacteremia, meningitis, endocarditis, endophthalmitis, pneumonia, and soft tissue diseases. Virulence factors allow this organism to induce diarrhea in addition to having dermonecrotic, cytotoxic, hemolytic properties resulting in a wide range of dermatologic presentations. Conclusion: We report a unique case of penile skin infection caused by B. cereus, an unusual culprit for an uncommon presentation successfully treated with fucidic acid ointment. This is the first case in literature describing such an entity.