Lactobacillus caseisubspecies casei endocarditis: a case report

Abstract

Lactobacillus sp., generally considered to be a harmless indigenous bacteria of the mucous membrane, occasionally causes serious infections. Lactobacillus endocarditis is a very rare disease, and no case has been reported in Korea. Gram-positive bacilli were isolated from blood cultures of a 41-year-old man with clinically suspected subacute bacterial endocarditis. The patient had a dental procedure 3 months prior to the infection. The isolate was identified as L. casei subsp. casei based on the cultural characteristics and gas liquid chromatography of metabolic products. The patient was treated with ampicillin and improved. When Lactobacillus is isolated from the blood of an endocarditis patient, the significance should be seriously considered.

Molecular Diagnosis of Endocarditis Due toLactobacillus caseisubsp.rhamnosus

“…tient reported that he did not eat yogurt every day [6] and that he had not undergone dental manipulation before admission to the hospital [4,[7][8][9][10]. Laboratory tests revealed an erythrocyte sedimentation rate of 45 mm/h and a WBC count of cells/L (70% polymorphonuclear neutrophils).…”

Safety Aspects of Lactobacillus and Bifidobacterium Species Originating from Human Oro-gastrointestinal Tract or from Probiotic Products

“…Lactobacillus endocarditis involved a substantial risk of relapse after medical therapy, and the occasional need for valve-replacement surgery to achieve cure (25,48). As in bacteremia cases L. casei group and also Lactobacillus plantarum were common findings in endocarditis (21,25,31,(48)(49)(50)(51)(52)(53)(54)(55). Like in the case of bacteremia, this reflects the common finding of these species in main sources of infection, rather than greater virulence (56).…”

Lactobacillus Endocarditis Necessitating Combined Mitral and Aortic Valve Replacement—A Case Report

“…7 % ) . [2][3][4][5][6]8,10 Clinical course is characterized by fever, chills or night sweats, chest pain, shortness of breath, fatigue, and weakness. Important signs include paleness, carious teeth, precordial murmur, and an enlarged spleen.1-1O Diagnosis has been confirmed by positive blood cultures'-'° or by TTE or TEE demonstration of structural heart disease and/or vegetations.…”

“…Of 34 patients,8 (23.5%) have died, and among 21 who completed the full course of antibiotic therapy,8 (38.1 % ) have experienced a relapse.3,8-1O Five of the 8 with a relapse were cured with a second course of antibiotics.…”