Table 1.

Clinical Characteristics of Neuroinvasive Bacillus cereus Infections

						Symptoms		Radiographic Findings		Treatment
No.	Age, y	Sex	Induction Regimen	No. of Positive Cultures	Antimicrobial MICs	Presenting	Neurologic	CNS	Other	Initial Combined Regimena	Ciprofloxacin Duration, mo
1	≥50	M	Cytarabine + daunorubicin + venetoclax	2 sets (4/4 bottles)	Vancomycin, 4; ciprofloxacin, 0.25	Fever, diarrhea, abnormal liver function test results	Encephalopathy, right CN VII palsy, right hemiparesis	Left basal ganglia cerebral hemorrhage	Hepatic microabscesses	Vancomycin, ciprofloxacin	8
2	<50	M	FLAG-IDA	2 sets (4/4 bottles)	Vancomycin, 4; ciprofloxacin, 0.06	Diarrhea, hypotension	None	Rim-enhancing right internal capsule lesion	Enteritis	Vancomycin, ciprofloxacin	2
3	<50	F	Cytarabine + daunorubicin + crenolanib	mNGS (Karius)	NR	Fever, nausea, abdominal pain	Headache, photophobia, meningismus	Left frontal lobe rim-enhancing lesion with hemorrhagic focus	None	Vancomycin, meropenem	8
4	<50	F	Cytarabine + daunorubicin + venetoclax	4 sets (7/8 bottles)	Vancomycin, 4; ciprofloxacin, 0.25	Fever, diarrhea, abdominal pain	Headache	Right and left frontal subarachnoid hemorrhage	Typhlitis, hepatic microabscesses	Vancomycin, ciprofloxacin	2
5	≥50	M	Cytarabine + daunorubicin + venetoclax	2 sets (4/4 bottles)	Vancomycin, 4; ciprofloxacin, 0.06	Fever, diarrhea, rectal pain	Encephalopathy, left hemiparesis, aphasia	Right and left frontal cerebral hemorrhage	Typhlitis, colitis, hypodense hepatic lesions	Vancomycin,meropenem, ciprofloxacin	5

Each patient had acute myeloid leukemia, and each 6-month outcome was survival.

Abbreviations: CN, cranial nerve; CNS, central nervous system; F, female; FLAG-IDA, fludarabine, cytarabine, granulocyte-stimulating colony factory, and idarubicin; M, male; MIC, minimum inhibitory concentration; mNGS, metagenomic next-generation sequencing; NR, not reported.

^aThe final treatment regimen was ciprofloxacin for all patients.