Aortic Valve Endocarditis Due to Lactobacillus casei Complicated by Stroke and Vertebral Osteomyelitis: A Case ReportWalker, Durane K. MD; Paez, Armando P. MDInfectious Diseases in Clinical Practice: January 2013 - Volume 21 - Issue 1 - p 66–68 doi: 10.1097/IPC.0b013e318260206b Case Reports Abstract Author Information Lactobacillus species are facultative gram-positive, catalase-negative anaerobic bacilli that are part of the normal bacterial flora of the human gastrointestinal mucosa. They are rarely considered a pathogen but have been reported to cause bacteremia with or without endocarditis among other infections including vertebral osteomyelitis, liver or pelvic abscesses, meningitis, and pneumonia. They can cause disease in patients who are immunocompetent and immunocompromised. Recommended treatment of choice for severe infections due to Lactobacillus species endocarditis is high-dose penicillin in combination with an aminoglycoside. From the Department of Infectious Diseases, Baystate Medical Center, Springfield MA. Correspondence to: Durane K. Walker, MD, Department of Infectious Diseases, Baystate Medical Center, 759 Chestnut St, Springfield MA, 01199. E-mail: firstname.lastname@example.org. The authors have no funding or conflicts of interest to disclose. © 2013 Lippincott Williams & Wilkins, Inc.