title: Liver abscess and bacteremia caused by lactobacillus: role of probiotics? Case report and review of the literature.
abstract: BACKGROUND
  Lactobacilli are non-spore forming, lactic acid producing, gram-positive rods. They are a part of the normal gastrointestinal and genitourinary microbiota and have rarely been reported to be the cause of infections. Lactobacilli species are considered non-pathogenic organisms and have been used as probiotics to prevent antibiotic associated diarrhea. There are sporadic reported cases of infections related to lactobacilli containing probiotics.
  
  
  METHODS
  In this paper we discuss a case of an 82 year old female with liver abscess and bacteremia from lactobacillus after using probiotics containing lactobacilli in the course of her treatment of Clostridium difficile colitis. The Lactobacillus strain identification was not performed and therefore, both commensal microbiota and the probiotic product should be considered as possible sources of the strain.
  
  
  CONCLUSIONS
  Lactobacilli can lead to bacteremia and liver abscesses in some susceptible persons and greater awareness of this potential side effect is warranted with the increasing use of probiotics containing lactobacilli.
authors.affiliation: Section of Gastroenterology and Hepatology, Georgia Regents University, 1120 15th Street-AD 2226, Augusta, GA, USA.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Sherid
authors.affiliation: Department of Medicine, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 East Huron Street, Suite 16-738, Chicago, IL, 60611, USA.
authors.forename: Salih
authors.initials: S
authors.lastname: Samo
authors.affiliation: Department of Internal Medicine, Froedtert Hospital & Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA.
authors.forename: Samian
authors.initials: S
authors.lastname: Sulaiman
authors.affiliation: Department of Internal Medicine, Seton Hall University, School of Health and Medicine Sciences, Trinitas Regional Medical Center, 225 Williamson Street, Elizabeth, NJ, 07202, USA.
authors.forename: Husein
authors.initials: H
authors.lastname: Husein
authors.affiliation: Section of Gastroenterology and Hepatology, Georgia Regents University, 1120 15th Street-AD 2226, Augusta, GA, USA.
authors.forename: Humberto
authors.initials: H
authors.lastname: Sifuentes
authors.affiliation: Section of Gastroenterology and Hepatology, Georgia Regents University, 1120 15th Street-AD 2226, Augusta, GA, USA. ssridhar@gru.edu.
authors.forename: Subbaramiah
authors.initials: S
authors.lastname: Sridhar
mesh_terms: D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology*; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000382:microbiology / Q000628:therapy; D003092:Colitis / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D007778:Lactobacillus; D008100:Liver Abscess / Q000382:microbiology*; D019936:Probiotics / Q000009:adverse effects*
keywords: Cholecystectomy; Lactobacillus; Liver abscess; Probiotics