Lactobacillus fermentum, a pathogen in documented cholecystitis

Abstract

While the routine use lactobacillus species as a probiotic is supported in the literature, understanding its potential role as a pathogen may allow more judicious use of these bacteria and encourage research to elucidate the pathogenicity of lactobacillus species.

Acute Cholecystitis Complicated with Gallbladder Perforation and Peritonitis Caused by Vancomycin-resistant Lactobacillus paracasei

“…is rare; bile fluid is typically infected with Escherichia coli, Enterococcus spp., Klebsiella spp., Enterobacter spp., Clostridium spp., and Bacteroides fragilis group [6]. To the best of our knowledge, there are only four other case reports worldwide thus far reporting primary pathogenic Lactobacillus in the setting of acute cholecystitis, only two of which are from within the United States and only one of which was complicated with peritonitis just like our patient's case [7][8][9][10].…”

Breaking Bad: a case of Lactobacillus bacteremia and liver abscess

“…A PubMed and ClinicalKey review of the literature identified six cases (out of eight reported cases of Lactobacillus liver abscess) that occurred in diabetics. However, each of those reported cases had an additional underlying disease process, particularly involving the hepatobiliary system such as post-cholecystectomy, ERCP, cholangitis, and Mirizzi syndrome, or other intestinal pathology including Crohn's disease [10,12,14,16,17]. Our patient only had uncontrolled diabetes thus predisposing him to increased risk of endothelial injury and bacterial translocation.…”

“…Other case reports (Appendix; Table 2) have identified probiotics as the etiology for the development of Lactobacillus liver abscess [9,17]. The use of probiotics has become widespread over the past few decades.…”

“…Although rare, Lactobacillus liver abscess has been reported in a total of 9 case reports in the literature [9][10][11][12][13][14][15][16][17]. Review of literature was done using keywords 'lactobacillus' 'liver abscess' 'bacteremia', through PubMed and MeSH databases with no restrictions for date range.…”

Scientific Opinion on the update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA†

“…This illustrates the ability of microorganisms, even those considered harmless, to colonise patients suffering from life‐threatening illnesses. Out of the rest, single reports associated L. paracasei (Franko et al., ), L. fermentum (Chery et al., ), L. acidophilus (Mehta et al., ), L. gasseri (Sun et al., ) and L. casei (Aroutcheva et al., ) with production of endocarditis, cholecystitis, septicaemia, surgical wound/urinary tract infection and contamination of a central catheter, respectively, in patients who have suffered from prostate cancer, coronary disease, lymphoma, simultaneous infection by a coagulase‐negative Staphylococcus and chronic lung and renal insufficiency.…”