A Rare Case of <i>Lactobacillus acidophilus</i> Presenting as Mitral Valve Bacterial Endocarditis

Makaryus, Amgad N.; Yang, Rayson; Hahn, Rebecca T.; Kort, Smadar

doi:10.1111/j.1540-8175.2005.04054.x

Cited by 11 publications

(14 citation statements)

References 9 publications

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“…Although Lactobacillus are usually considered nonpathogenic flora of the mouth, gut, and female genital tract, Makaryus et al 40 . reported a case of a 63‐year‐old woman who developed mitral valve endocarditis secondary to infection with L. acidophilus .…”

Section: Effects Of Probiotic Translocation In Immunocompromised Indimentioning

confidence: 99%

“…38 Commonly, these infections can be correlated with previous illnesses such as recent surgery, organ transplant, valvulopathy, diabetes mellitus, AIDS, and cancer with either immunosuppressive therapy or antibiotic treatment, which could promote the development or the selection of the microorganism. 39 Although Lactobacillus are usually considered nonpathogenic flora of the mouth, gut, and female genital tract, Makaryus et al 40 reported a case of a 63-year-old woman who developed mitral valve endocarditis secondary to infection with L. acidophilus. The woman was reported to have a medical history of ovarian cancer, and had received multiple cycles of chemotherapy.…”

Section: Effects Of Probiotic Translocation In Immunocompromised Indimentioning

confidence: 99%

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Safety of probiotics: translocation and infection

2008

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The long history of safety has contributed to the acceptance of probiotics as a safe food adjunct. Consequently, many probiotic products and their applications have been granted GRAS (generally regarded as safe) status. However, this classification has been frequently generalized for all probiotic strains regardless of their application. Cases of probiotics from the genera Lactobacillus, Leuconostoc, Pediococcus, Enterococcus, and Bifidobacterium have been isolated from infection sites, leading to the postulation that these probiotics can translocate. Probiotic translocation is difficult to induce in healthy humans, and even if it does occur, detrimental effects are rare. Despite this, various reports have documented health-damaging effects of probiotic translocation in immunocompromised patients. Due to probiotics' high degree of safety and their morphological confusion with other pathogenic bacteria, they are often overlooked as contaminants and are least suspected as pathogens. However, the antibiotic resistance of some strains has increased the complexity of their eradication. Probiotic translocation and infection deserve further investigation and should become a facet of safety assessment so the negative effects of probiotics do not outweigh the benefits.

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Section: Effects Of Probiotic Translocation In Immunocompromised Indimentioning

confidence: 99%

Section: Effects Of Probiotic Translocation In Immunocompromised Indimentioning

confidence: 99%

Safety of probiotics: translocation and infection

2008

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“…To our knowledge, only 28 cases (3 cases in Japan), including this case, of infectious endocarditis caused by lactobacilli have been reported since 1992 after the publication of Duke's criteria (4,(6)(7)(8)(9).…”

Section: Discussionmentioning

confidence: 93%

Infectious Endocarditis Caused by <i>Lactobacillus acidophilus</i> in a Patient with Mistreated Dental Caries

et al. 2012

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We present a rare case of infectious endocarditis caused by Lactobacillus acidophilus in a patient on longterm steroid use for autoimmune hepatitis. In vitro susceptibility-guided antibiotics with benzylpenicillin plus clindamycin and successive mitral annuloplasty resulted in a favorable outcome. Infectious endocarditis was suspected to be a complication of mistreated periodontal infection. Maintenance of oral hygiene is important in immunocompromised patients.

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“…Lactobacillus species other than Lactobacillus acidophilus account for the largest proportion of cases. 1 An overall mortality rate of greater than 20% has been reported from LB endocarditis. 3 Some evidence suggests that the increasing use of colonoscopy may increase the incidence of Lactobacilllus bacteremia and subsequent endocarditis.…”

Section: Discussionmentioning

confidence: 99%

“…It is a commensal of human mucosal tissues and is considered as nonpathogenic flora of the mouth, gut, and female genital tract. 1 Lactobacilli have been employed as probiotic bacteria, either in lyophilized form or as a fermented food product. They have been shown to be effective in the treatment of infantile and adult diarrhea, antibiotic-associated diarrhea, and candidal vaginitis.…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus-Cause of Death

Arshad

Gopalakrishna

Maroo

et al. 2010

Infectious Diseases in Clinical Practice

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Lactobacillus, a nonspore-forming gram-positive rod, is a facultative anaerobic organism. It is a commensal of human mucosal tissues and is a nonpathogenic flora of the mouth, gut, and female genital tract. Lactobacillus has been used as a probiotic bacteria to treat diarrhea and is also present in dairy foods. It is hence commonly used. Lactobacillus endocarditis, an exceedingly unusual disorder, is accompanied by high mortality and poor response to treatment. We report a 64-year-old man with nonspecific symptoms of infective endocarditis due to Lactobacillus. Despite adequate therapy, the patient experienced both an embolic and hemorrhagic stroke and subsequently died. (Infect Dis Clin Pract 2010;18: 219Y220)L actobacillus (LB) endocarditis, an exceedingly unusual disorder, is accompanied by high mortality and poor response to treatment. We report a fatal case of LB endocarditis in a 64-year-old man with nonspecific symptoms of infective endocarditis due to LB. Despite therapy, the patient experienced both an embolic and hemorrhagic stroke and died. CASE REPORTA 64-year-old white male with aortic stenosis, status postYbioprosthetic valve replacement in 2005, and a history of recurrent epistaxis presented with a 3-month history of increasing weakness, fatigue, and weight loss. On examination, the blood pressure was 91/59 mm Hg, heart rate 71 beats per minute, and temperature 99-C. There was a grade 2/6 ejection systolic murmur in the aortic area. Blood cultures were taken, and all 4 bottles of 2 sets grew Lactobacillus acidophilus. This was speciated using RapID ANA II System (Remel, Lanexa, Kans). Transesophageal echocardiography was obtained, which showed vegetations on the prosthetic aortic valve (Figs. 1A and B). Intravenous (IV) aqueous penicillin G at 4 million units every 4 hours and gentamicin at 1 mg/kg of body weight were begun, and after a few days, the patient was sent home from the hospital on IV penicillin G. The patient's immunoglobulin levels, complement, and antinuclear antibody were normal. Two sets of blood cultures each were repeated on days 5 and 10 and 33 after therapy, and there were no organisms isolated. Two weeks later, he returned with severe epistaxis and expressive aphasia, which resolved within 9 hours. Computerized tomography (CT) of the brain with contrast showed a left frontal lobe subacute infarct. He was scheduled for aortic valve replacement surgery. While awaiting for a valve replacement surgery, he experienced 2 episodes of falling because his Bleg gave away.[ A second CT of the brain without contrast showed an acute subarachnoid hemorrhage and a possible right middle cerebral artery aneurysm. However, magnetic resonance imaging/magnetic resonance angiogram and CT angiogram failed to confirm an aneurysm, embolus, or vasculitis. The patient was continued on IV penicillin G and moved to a rehabilitation unit. He returned to the emergency room 5 days after discharge from a rehabilitation unit with persistent epistaxis. On the third day of rehospitalization, he was found on the ...

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A Rare Case of Lactobacillus acidophilus Presenting as Mitral Valve Bacterial Endocarditis

Cited by 11 publications

References 9 publications

Safety of probiotics: translocation and infection

Safety of probiotics: translocation and infection

Infectious Endocarditis Caused by <i>Lactobacillus acidophilus</i> in a Patient with Mistreated Dental Caries

Lactobacillus-Cause of Death

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