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Lactobacillus Bacteremia Associated With Probiotic Use in a Pediatric Patient With Ulcerative Colitis

Vahabnezhad, Elaheh MD*; Mochon, Albert Brian PhD; Wozniak, Laura Joyce MD*; Ziring, David Alexander MD*

Journal of Clinical Gastroenterology: May/June 2013 - Volume 47 - Issue 5 - p 437–439
doi: 10.1097/MCG.0b013e318279abf0
ALIMENTARY TRACT: Case Report
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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.

Departments of *Pediatrics Gastroenterology

Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA

The authors declare that they have nothing to disclose.

Reprints: Elaheh Vahabnezhad, MD, Department of Pediatric Gastroenterology, University of California, 10833 Leconte Avenue, 12-383 MDCC, Los Angeles, CA 90095 (e-mail: evahabnezhad@mednet.ucla.edu).

© 2013 by Lippincott Williams & Wilkins