• A 20-year-old student presents to the Emergency Department with sudden onset of abdominal pain, vomitting, and non-bloody diarrhea. A couple of hours earlier, he had eaten fried rice and beef which had been left on the counter by his roomate after being reheated in the microwave.
  • Classification
    • gram-positive, spore-forming bacilli
      • Bacillus cereus
  • Pathogenesis
    • transmission
      • foodborne
        • chinese fried rice 
    • molecular biology
      • 2 toxins
        • emetic toxin 
          • cereulide, a preformed toxin
          • associated with fried rice and pasta
          • symptoms similar to S. aureus (vomitting and diarrhea)
          • usually within 1-5 hours
        • diarrheal toxin
          • produced in vivo
          • associated with meats and sauces
          • symptoms similar to E. coli (↑cAMP → watery diarrhea)
          • usually within 8-18 hours
  • Symptoms
    • food poisoning (gastroenteritis)
      • no blood
      • with or without vomiting
      • symptoms start and end quickly
  • Diagnose clinically or with stool culture and commercial assays
  • S. aureus food poisoning
    • usually custard, mayonnaise, and potato salad are implicated
  • Self-limiting
Prognosis, Prevention, and Complications
  • Prevention
    • proper handling and storage of cooked food

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