Risk of T-cell NHL is increased with TNF-α inhibitor use in combination with thiopurines but not with TNF-α inhibitors alone.

SUMMARY Background

BackgroundLactobacilli 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.Case presentationIn 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.ConclusionLactobacilli 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.

Endoscopic findings of the colon were different; the first case demonstrated a reddened colonic fold without an obvious mass and the other had an ulcerated friable mass. Both of the tumors had positive immunohistochemical stains for CD31 and CD34 (one was also positive for CD117). Surgery was not performed in either case. Treatment included chemotherapy with imatinib for the first patient and paclitaxel for the second. Prognosis for this tumor is generally poor; in our cases, one patient was still alive after 5 months of follow-up and the other died within 2 months of diagnosis. After presenting our cases, we reviewed the current literature on angiosarcoma of the colon.