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Poor Outcome of Rare Lactobacillus Bacteremia and Endocarditis in a Patient With Frequent Consumption of Live Culture Yogurts.

J Community Hosp Intern Med Perspect

January 2025

Division of Infectious Disease, Department of Internal Medicine, Naples Comprehensive Health, Naples, FL, USA.

is a gram-positive bacterium commonly found in dairy products and used as a probiotic due to its resistance to acid and bile. While generally considered safe, rare cases of bacteremia and endocarditis have been reported, primarily in individuals with significant risk factors. This report discusses an elderly male with a history of cardiovascular diseases, diabetes, and asthma, who developed bacteremia and endocarditis after consuming large quantities of Greek yogurt.

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Background: Lacticaseibacillus (formerly Lactobacillus) rhamnosus is widely used in probiotics or food supplements to promote microbiome health and may also be part of the normal microbiota of the human gastrointestinal tract. However, it rarely also causes invasive or severe infections in patients. It has been postulated that these infections may originate from probiotics or from endogenous commensal reservoirs.

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Bacteria of the genus are microaerophilic or aerotolerant anaerobic Gram-positive non-spore-forming rods. They are considered essential members of the human gut microbiome; however, recent studies have revealed that these microorganisms are less predominant in the gut microbiome than initially thought. spp.

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Lactobacilli are facultative anaerobic, gram-positive, rod-shaped bacteria found in the normal flora of the oral cavity and the gastrointestinal and genitourinary tracts. This report presents a case of infective endocarditis and provides echocardiographic evidence of its pathogenic potential. Furthermore, we provide an account of the first successful treatment with daptomycin to our knowledge.

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We report a rare case of aorto-bi-iliac prosthetic allograft mucormycosis in a 57-year-old immunocompetent patient in France. Outcome was favorable after surgery and dual antifungal therapy with liposomal amphotericin B and isavuconazole. In a literature review, we identified 12 other cases of prosthetic vascular or heart valve mucormycosis; mortality rate was 38%.

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