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Bacillus cereus  isolates have been described harboring  Bacillus anthracis  toxin genes, most notably  B .  cereus  G9241, and capable of causing severe and fatal pneumonias. This report describes the characterization of a  B .  cereus  isolate, BcFL2013, associated with a naturally occurring cutaneous lesion resembling an anthrax eschar. Similar to G9241, BcFL2013 is positive for the  B .  anthracis  pXO1 toxin genes, has a multi-locus sequence type of 78, and a  pagA  sequence type of 9. Whole genome sequencing confirms the similarity to G9241. In addition to the chromosome having an average nucleotide identity of 99.98% when compared to G9241, BcFL2013 harbors three plasmids with varying homology to the G9241 plasmids (pBCXO1, pBC210 and pBFH_1). This is also the first report to include serologic testing of patient specimens associated with this type of  B .  cereus  infection which resulted in the detection of anthrax lethal factor toxemia, a quantifiable serum antibody response to protective antigen (PA), and lethal toxin neutralization activity.

Anthrax Toxin-Expressing Bacillus cereus Isolated from an Anthrax-Like Eschar