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Lactobacillus bacteremia associated with probiotic use in a pediatric patient with ulcerative colitis

Elaheh Vahabnezhad1, Albert Brian Mochon, Laura Joyce Wozniak

  • 1Departments of Pediatrics Gastroenterology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. evahabnezhad@mednet.ucla.edu

Journal of Clinical Gastroenterology
|February 22, 2013
PubMed

Insights

Probiotic use of Lactobacillus rhamnosus GG led to bacteremia in an immunosuppressed teen with ulcerative colitis. This highlights potential risks in immunocompromised patients.

Area of Science:

  • Gastroenterology
  • Microbiology
  • Immunology

Background:

  • Lactobacillus species are common gastrointestinal flora.
  • Probiotic strains of Lactobacillus are widely used clinically with limited supporting evidence.
  • Bacteremia from probiotic Lactobacillus strains is rare.

Observation:

  • A 17-year-old boy with ulcerative colitis on corticosteroids and infliximab developed fever, flushing, and chills.
  • Symptoms began one week after initiating Lactobacillus rhamnosus GG probiotics.
  • Blood cultures confirmed Lactobacillus bacteremia, matching the probiotic strain.

Findings:

  • 16S rRNA sequencing confirmed L. rhamnosus in blood and probiotic samples.
  • The patient was treated empirically with antibiotics and defervesced.
  • Subsequent blood cultures were negative after initial positive results.

Implications:

  • This case highlights the potential risk of Lactobacillus bacteremia in immunosuppressed patients.
  • Immunocompromised individuals with severe ulcerative colitis may be at increased risk.
  • Further research is needed to assess the safety of probiotics in immunocompromised populations.

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