Probiotic Related Lactobacillus rhamnosus Endocarditis in a Patient with Liver Cirrhosis and Literature Review

Naqvi SSB, Hofmeyr A and Na

Abstract

Lactobacillus is a commensal in gastrointestinal and genitourinary flora and considered as a friendly bacterium with low pathogenicity. Many species of Lactobacillus including Lactobacillus rhamnosus are now available as probiotics and their use has widely increased in recent years. Lactobacillus has propensity to cause invasive infections such as bacteraemia and endocarditis predominantly in an immune compromised host. We report a case of fatal Lactobacillus endocarditis involving a young patient with a history of complicated cirrhosis and prior Clostridium difficile colitis; and present a literature review and discussion of the possible association of systemic infection with ‘probiotic’ formulations containing Lactobacillus species.