title: Lactobacillus bacteremia associated with probiotic use in a pediatric patient with ulcerative colitis.
abstract: Probiotic strains of Lactobacillus are currently used in a variety of clinical practices with limited evidence to support their use. Lactobacillus species are a normal part of gastrointestinal flora, and bacteremia with probiotic strains of Lactobacillus is very uncommon. We describe a case of Lactobacillus bacteremia in a 17-year-old boy with ulcerative colitis managed with systemic corticosteroids and infliximab, who presented with fever to 102°F, flushing, and chills 1 week after starting Lactobacillus rhamnosus GG probiotics. Initial blood culture on day 2 of his fever was positive for Lactobacillus, however, subsequent blood cultures on day 3 and 5 were negative. He was treated empirically with antibiotics for 5 days and defervesced by day 8 of his illness. 16 S rRNA sequence analysis identified the organism from the patient's blood culture and probiotic capsule as L. rhamnosus with a 99.78% match for both the strains. This case report highlights the potential risk of Lactobacillus bacteremia in immunosuppressed patients with severe active ulcerative colitis.
authors: Departments of Pediatrics Gastroenterology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. evahabnezhad@mednet.ucla.edu
authors: Elaheh
authors: E
authors: Vahabnezhad
authors: Albert Brian
authors: AB
authors: Mochon
authors: Laura Joyce
authors: LJ
authors: Wozniak
authors: David Alexander
authors: DA
authors: Ziring
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D003093:Colitis, Ulcerative / Q000628:therapy*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D052201:Lacticaseibacillus rhamnosus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D008297:Male; D019936:Probiotics / Q000009:adverse effects* / Q000627:therapeutic use*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012307:Risk Factors; D017422:Sequence Analysis, DNA
chemical_list: D000900:Anti-Bacterial Agents; D012336:RNA, Ribosomal, 16S