Fungemia Por Saccharomyces Cerevisiae Em Paciente Pediátrico Após Tratamento Com Probiótico

Abstract

Objective: To report the case of a one-year-old patient with a bloodstream infection associated with probiotics, and to discuss the indications and precautions concerning the therapeutic use of probiotics. Case description: A one-year-old male patient with Down syndrome in a late postoperative period of congenital cardiac disease correction. The patient was severely malnourished and had been hospitalized since he was two months old in the Pediatric Intensive Care Unit. While in the hospital, the patient presented multiple infections related to mechanical ventilation and invasive devices, and received recurrent treatment with broadspectrum antibiotics for long periods. The patient developed chronic diarrhea and feeding intolerance, which lead to the use of probiotics (Saccharomyces boulardii) for four days. Two days after the end of the treatment, the patient developed septic shock, and the Saccharomyces cerevisiae was isolated in the central and peripheral blood cultures. After antifungal treatment (Amphotericin B), the blood cultures were negative. The patient had no further clinical complications after this event. Comments: Despite the well-documented benefits of probiotics in some clinical situations, we should be cautious about the indication of their use, preparation, and administration, in addition to the safe handling of invasive devices.

Antioxidants Maintain Cellular Redox Homeostasis by Elimination of Reactive Oxygen Species

“…In IBD patients, chronic oxidative stress leads to a tissue destruction and disrupts the microbial balance. Studies have found some beneficial microbes function through fermentation and microbial metabolic products help to prevent the gut damage [137, 138]. However, the human clinical trials showed the variables results about the microbes function in IBD, the causal effect of the microbiotia with the development of IBD is still under active investigation shown in Fig.…”

“…However, the human clinical trials showed the variables results about the microbes function in IBD, the causal effect of the microbiotia with the development of IBD is still under active investigation shown in Fig. 3 [138, 139]. …”

Rare Invasive Yeast Infections in Greek Neonates and Children, a Retrospective 12-Year Study

“…However, it might also be responsible for IFI particularly in vulnerable patients receiving probiotics or critically ill patients with severe underlying diseases such as cancer [ 14 ]. Few cases in the literature refer to pediatric population, and all were treated effectively [ 15 , 16 , 17 ]. The antifungal agent of choice has not been established.…”

Can use of probiotics drugs cause fungemia? – a literature review

“…One of the first cases of S. cerevisiae fungemia, a species that previously included the S. boulardii species, was described in 1980, in a 59-year-old patient from Louisiana, United States, who suffered burns and was treated with hyperalimentation (including probiotic use) (Eschete & West, 1980). As of this date, several other cases (Lolis et al, 2008, Thygesen et al, 2012, Chioukh et al, 2013, Eren et al, 2014, Santino et al, 2014, Appel-da-Silva et al, 2017, Atıcı et al, 2017, Martin et al, 2017, Romanio et al, 2017, Roy et al, 2017, Kara et al, 2018, Landaburu et al, 2020, Poncelet et al, 2021, Rannikko et al, 2021 reinforced the correlation between the microorganism that makes up probiotic drugs and those present in samples of patients with fungemia. Despite this, microorganism origin confirmation is necessary to adequately suggest the association.…”