Twice isolated, not twice ignored: Bacillus cereus catheter-related bloodstream infection in a haemodialysis patient.

A 53-year-old man with chronic kidney disease on maintenance haemodialysis via a right internal jugular tunnelled catheter (permcath) presented with recurrent fever during dialysis sessions. Paired blood cultures from the catheter and peripheral vein yielded Bacillus cereus. As the organism is frequently regarded as a contaminant, repeat paired cultures were obtained, which again grew B. cereus susceptible to vancomycin and gentamicin. Catheter-drawn cultures flagged positive earlier than peripheral cultures in both sets (differential time to positivity approximately 6.2 h and 5.5 h). Echocardiography excluded infective endocarditis. The patient improved following catheter removal and antimicrobial therapy. This case highlights the importance of distinguishing contamination from true bloodstream infection.