Welders and other metal workers may become infected with a strain of Bacillus cereus that causes an anthrax-like disease.
Patients: welders, metal worker
Organism: Bacillus cereus, Bacillus tropicus
Pathogenesis: pXO1 virulence gene that produces anthrax toxins
The reason for the increased risk in welders and metal workers is unknown. It may be due to higher levels of iron or other metals need for Bacillus growth. Alternatively, alcohol misuse has been implicated.
Clinical features:
(1) fever and/or chills
(2) dyspnea
(3) hypoxemia with reduce SpO2
(4) leukocytosis
(5) variable diarrhea
(6) hemoptysis or blood sputum (key finding)
(7) pneumonia on chest X-ray
(8) variable meningitis
(9) tachycardia
(10) tachypnea
(11) hypothermia or hyperthermia
(12) hypotension
A Bacillus species may be isolated from respiratory specimens and/or blood cultures.
Therapy consists of bactericidal antibiotics plus antitoxin.
