Two different toxins can be produced by Bacillus cereus:

• Emetic toxin: the heat and pH-stable cereulide toxin is produced by B. cereus directly in the food. Symptoms range from nausea and vomiting to liver failure.
• Diarrheal toxins: heat-labile protein toxins that can be broken down by digestive enzymes. Toxin production occurs only in the intestines. Symptoms are triggered by the intake of a sufficiently high number of B. cereus.