Bacillus cereus-induced myonecrosis.

A patient with an incomplete amputation due to a crush injury to his arm developed a myonecrosis with Gram-positive rods noted on muscle and wound aspirates. The patient was treated for a probable Clostridium perfringens infection but culture results proved the organism to be Bacillus cereus. In light of the reported resistance of Bacillus cereus to penicillin, this case serves to emphasize the importance of expanded empiric coverage with high-dose penicillin and an aminoglycoside pending the return of culture and sensitivity results.