Lactobacillus infections and endocarditis have been reported in the medical literature for years. Scattered case reports and several case series have been published since the 1930s. A new mechanism of disease pathogenesis, however, has altered the clinical appearance of lactobacillus infections. Probiotic agents, serving as an entry vehicle for lactobacillus, have been identified in the genesis of these infections.Case report:
A 42-year-old man had Lactobacillus casei endocarditis, most likely originating from his dentition. He underwent successful mitral valve replacement as well as repair of an atrial septal defect after a full dental extraction. There was no history suggestive of probiotics or vitamin use, or excessive dietary intake of dairy products.Conclusions:
Lactobacillus infections, particularly endocarditis, are infrequently encountered, although they remain to be clinically important causes of infection. When treating endocarditis, determining the origin of the bacteremia is essential, and a search must include dietary origins. Physicians must recognize that lactobacilli are true pathogens and may present with an unusual pathway terminating in infection. Clinicians should also be aware of the possibility for an increasing number of lactobacillus infections.