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患者,男,6岁,体瘦弱。1998年9月因发热头痛来本院就诊。查体:浅反射减弱,神志恍惚,体温38～40℃,Hb 116g/L,WBC16. 8×10~9/L,N 0.88,L 0.12,临床诊断为病毒性脑炎合并感染,两次血培养均查到蜡样芽孢杆菌,脑脊液培养阴性。经临床应用该菌敏感药物和抗病毒药物治疗,症状消失,10d后痊愈。细菌分离鉴定:①培养特性:无菌取患者静脉血5ml接种到血液增菌培养基中,经35℃ 48h培养,血培养基均匀混浊,有菌膜,转种血平板35℃ 24 h培养,形成灰白色直径4～5mm不透明菌落,菌落呈现腊样光泽,边缘不整齐,周围有β～溶血环。革兰氏染色示G~+粗大杆菌,短链状排列,无荚膜,菌体中间有芽孢,不膨大。②生化特性:触酶（+）,氧化酶（+）,能分解葡萄糖、蔗糖、麦芽糖、水杨苷、蕈糖,不分解乳糖、木糖、鼠李糖、甘露醇和肌醇,IMVIC试验为--+-,不产生H_2S,不分解尿素.明胶液化试验和卵磷脂酶试验均阳性,有动
Patient, male, 6 years old, the body is thin. September 1998 because of fever headache to our hospital. Examination: weakened shallow reflex, trance, body temperature 38 ~ 40 ℃, Hb 116g / L, WBC16 8 × 10 ~ 9 / L, N 0.88, L 0.12, clinical diagnosis of viral encephalitis with infection, Culture were found Bacillus cereus, cerebrospinal fluid culture negative. The clinical application of the bacteria sensitive drugs and antiviral drugs, the symptoms disappear, recovered after 10d. Isolation and identification of bacteria: ① culture characteristics: aseptic take patients venous blood 5ml inoculated into the blood enrichment medium, after 35 ℃ 48h culture, the blood medium turbid, a membrane, transplanted blood plate 35 ℃ 24 h culture, The formation of white and white diameter 4 ~ 5mm opaque colonies showed waxlike luster, irregular edges, surrounded by β ~ hemolysis ring. Gram stain showed G ~ + crude bacilli, short chain arrangement, no capsule, bacteria in the middle spores, not swollen. ② biochemical characteristics: catalase (+), oxidase (+), can decompose glucose, sucrose, maltose, salicin, mushroom sugar, do not break down lactose, xylose, rhamnose, mannitol and inositol, IMVIC test - + -, does not produce H_2S, does not decompose urea. Gelatin liquefaction test and lecithin test were positive, there is a move