"All He Did Was Reheat and Eat Fried Rice Made the Day Before"... Man in His 20s Nearly Needed a Liver Transplant

Cereulide Toxin Detected in Food and Blood
Acute Liver Failure and Kidney Damage... Recovered After Intensive Care

A case has been reported in which a man who reheated and ate a rice dish cooked the previous day developed multiple organ failure, including acute liver failure and kidney injury, and doctors had to consider a liver transplant.

Fried rice. Stock photo: Pixabay.

On October 5, the international journal BMJ Case Reports published a paper by researchers at Erasmus MC University Medical Center Rotterdam in the Netherlands, titled “Fulminant multiple organ failure associated with cereulide-producing Bacillus cereus after consumption of improperly stored cooked rice.”

According to the paper, the man left a rice dish cooked the previous day on the kitchen counter overnight and reheated it the following day. The kitchen temperature was above 30 degrees Celsius. After eating, he began to feel unwell and went to bed early. The next morning, he was found unconscious.

By the time he was taken to the hospital, the man was experiencing generalized seizures and severe hypoglycemia. Tests showed that his liver function had deteriorated rapidly, his blood ammonia level had risen, and his kidney function was impaired. Doctors determined that he might need an emergency liver transplant and transferred him to a hospital that could perform one.

High concentrations of cereulide, a toxin produced by Bacillus cereus, were later detected in the man's food and blood. A sibling who ate the same food experienced vomiting and diarrhea but recovered within two days, while the man's condition rapidly worsened without vomiting or diarrhea.

Photo is not directly related to the article. Pixabay.

Bacillus cereus is a bacterium commonly found in natural environments such as soil and can cause food poisoning in starchy foods such as rice and pasta. Cereulide, which can cause the vomiting form of food poisoning, is particularly heat-resistant. Although some bacteria may be killed during cooking, heat-resistant spores can survive. If cooked food is left at room temperature for too long, the bacteria can multiply and produce the toxin. Even reheating the food may not sufficiently eliminate toxin that has already formed.

Doctors provided intensive care, including glucose administration, treatment to correct toxin-related metabolic abnormalities, dialysis, and support for breathing and blood pressure. The man's liver function began to improve on the third day of hospitalization, and he was removed from the liver transplant waiting list on the fourth day. His kidney function also recovered, and he was discharged. After rehabilitation, he returned to his everyday life.

Food poisoning after eating cooked rice is usually mild, but in severe cases it can lead to life-threatening complications, including acute liver failure and kidney injury. A case study from Austria published in 2022 also reported food poisoning symptoms in five adults who ate fried rice contaminated with Bacillus cereus. One of the patients developed life-threatening liver failure and kidney injury.

This content was produced with the assistance of AI translation services.