Journal Article

Lactobacillus Bacteremia and Endocarditis: Review of 45 Cases

Rola N. Husni, Steven M. Gordon, John A. Washington and David L. Longworth

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 5, pages 1048-1055
Published in print November 1997 | ISSN: 1058-4838
Published online November 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516109
Lactobacillus Bacteremia and Endocarditis: Review of 45 Cases

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Lactobacilli are part of normal gastrointestinal and genitourinary flora but are an uncommon cause of bacteremia. We reviewed the cases of 45 patients with clinically significant lactobacillus bacteremia occurring over 15 years. Underlying conditions were common, including cancer (40%), recent surgery (38%), and diabetes mellitus (27%). Twenty-two patients were in the intensive care unit at the time of onset of lactobacillus bacteremia. Eleven of the 45 patients were receiving immunosuppressive therapy, 11 were receiving total parenteral nutrition, and 23 had received antibiotics without activity against Lactobacillus prior to the occurrence of bacteremia. Bacteremia was polymicrobial in 27 patients and developed during hospitalization in 39. Thirty-one patients died, but only one death was attributable to lactobacillus bacteremia. Lactobacilli are relatively avirulent pathogens that produce bacteremia in patients with serious underlying illnesses, many of whom have received prior antibiotic therapy that may select out for the organism. While rarely fatal in itself, lactobacillus bacteremia identifies patients with serious and rapidly fatal illness.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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