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Septicemia due to Bacillus clausii after the use of probiotics. A complication to keep in mind
Michael Muñoz1, Elizabeth Castaño G2, Raúl Esquivel Suman2
1Universidad del Sinú, Montería, Colombia.
Insights
A probiotic, Bacillus clausii, caused sepsis in a malnourished infant. This case highlights the risks of using probiotics in immunocompromised children, emphasizing caution in vulnerable populations.
Area of Science:
- Microbiology
- Clinical Medicine
- Pediatrics
Background:
- Probiotics, including Bacillus clausii, are widely used for health benefits.
- Complications from Bacillus clausii are rare, especially in pediatric patients.
- This study focuses on a rare case of sepsis in an infant linked to Bacillus clausii.
Observation:
- A 4-month-old infant with protein-calorie malnutrition presented with severe diarrhea and dehydration.
- The infant received Enterogermina (containing Bacillus clausii) as part of initial treatment.
- The infant developed sepsis, with Bacillus clausii identified in blood cultures, alongside MRSA and Clostridioides difficile.
Findings:
- The infant exhibited signs of shock, respiratory distress, and impaired consciousness.
- Despite intensive care and multiple antibiotic treatments, the infant's condition worsened.
- The infant ultimately died from multisystem organ failure.
Implications:
- The use of probiotics in immunocompromised individuals, including those with malnutrition or severe diarrhea, warrants caution.
- Risk factors like malnutrition and intestinal damage may predispose patients to probiotic-induced bacteremia and sepsis.
- Healthcare providers should carefully assess risks before administering probiotics to vulnerable pediatric populations.
Abstract:
Probiotics are live microorganisms that benefit the host in different clinical situations. Bacillus clausii is one of the most frequently used, but it is not without risk. To date, there are few reports of complications secondary to this agent in pediatric patients.
Objective:
To describe the case of an infant who developed after treatment sepsis due to Bacillus clausii.
Clinical Case:
A 4-month-old female infant of indigenous ethnicity, from a rural area in the interior of Panama, 3 hours away from the nearest health sub-center by canoe, and with protein-calorie malnutrition, presented with acute diarrhea and moderate-severe dehydration, receiving Enterogermina as part of the initial treatment. She was transferred to a tertiary hospital, where she arrived with impaired consciousness, respiratory distress, and signs of shock. The initial blood culture reported growth of methicillin-resistant Staphylococcus aureus (MRSA), the gastrointestinal panel was positive for Clostridiodes difficile, and later serial blood cultures of peripheral blood and central venous catheter confirmed growth of Bacillus clausii. With a torpid evolution and resistance to multiple antibiotic schemes, she died due to multisystem organ failure twelve days after admission.
Conclusions:
The use of probiotics as concomitant treatment in patients with some degree of immunosuppression should be administered with caution, considering the presence of risk criteria for complications such as malnutrition or intestinal epithelial damage due to severe diarrhea since they predispose to the development of bacteremia and/or sepsis.
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