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Lactobacillus paracasei-induced lung abscess in a splenectomized patient: A rare case report
1Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
Medicine
|July 15, 2025
Summary
Lactobacillus paracasei, a probiotic, can cause lung abscesses in immunocompromised patients, particularly after splenectomy. Early diagnosis with next-generation sequencing and targeted antibiotics are crucial for recovery.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pulmonology
Background:
- Lactobacillus paracasei (LP) is typically a probiotic, rarely causing infections.
- Immunocompromised individuals, especially those who have undergone splenectomy, are at higher risk for opportunistic infections.
- This case report details a rare instance of LP causing a severe lung infection.
Purpose of the Study:
- To report a case of lung abscess caused by Lactobacillus paracasei in a splenectomized patient.
- To highlight the diagnostic utility of next-generation sequencing (NGS) in identifying rare pathogens.
- To emphasize the importance of tailored antibiotic therapy in managing opportunistic infections.
Main Methods:
- A 65-year-old splenectomized male presented with symptoms of infection.
- Diagnostic workup included imaging (revealing lung abscess, lymphadenopathy, adrenal nodules) and lung puncture biopsy.
- Next-generation sequencing (NGS) was employed for pathogen identification, confirming Lactobacillus paracasei.
- Treatment involved multidisciplinary collaboration and targeted antibiotic therapy with faropenem.
Main Results:
- Next-generation sequencing confirmed Lactobacillus paracasei as the causative agent of the lung abscess.
- The patient received targeted antibiotic treatment with faropenem.
- Clinical improvement was observed, with resolution of symptoms and successful hospital discharge.
Conclusions:
- Lactobacillus paracasei can act as an opportunistic pathogen, leading to severe lung abscesses in immunocompromised, splenectomized patients.
- Early and accurate diagnosis using NGS is critical for effective management.
- Multidisciplinary collaboration and pathogen-specific antibiotic therapy are essential for successful outcomes in such cases.
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