Gram-positive Organisms (4) Anthrax Bacillus anthracis Gram ⊕, spore-forming rod that produces anthrax toxin Only bacterium with a polypeptide capsule (contains d-glutamate) Cutaneous anthrax Painless papule surrounded by vesicles ulcer with black eschar (painless, necrotic) uncommonly progresses to bacteremia and death Pulmonary anthrax Inhalation of spores flu-like symptoms that rapidly progress to fever, pulmonary hemorrhage, mediastinitis, and shock death Also known as woolsorter’s disease
Bacillus cereus Gram ⊕ spore-forming rod Causes food poisoning (Reheated rice syndrome) Spores survive cooking rice Keeping rice warm results in germination of spores & enterotoxin formation Emetic type usually seen with rice and pasta N/V within 1–5 hr. Caused by cereulide, a preformed toxin Diarrheal type causes watery, nonbloody diarrhea and GI pain within 8–18 hrs.