Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, 14080, Mexico City, Mexico.
BMC Infect Dis. 2021 Jun 2;21(1):518. doi: 10.1186/s12879-021-06181-w.
Lactobacillus is a genus of Gram-positive non-spore-forming rods usually found in the microbiota of the oral cavity, gastrointestinal tract, and female genitourinary tract. Also, they are commonly used in the food industry as supplements and probiotics. Lactobacilli are normally considered non-pathogenic to the human body, however, under certain circumstances such as immunosuppression, they can cause severe infections, with only a few cases of bacteremia, infective endocarditis, pneumonia, meningitis, and intra-abdominal infections reported. Among these presentations, a pyogenic liver abscess is rather rare.
We describe the case of a 59-year-old man with a history of diabetes mellitus and multiple abdominal surgeries with the latest being in 2014 presenting with bacteremia and multiple large pyogenic liver abscesses due to Lactobacillus gasseri, which did not appear to be related to the use of probiotics or immunosuppression.
Given the high prevalence of diabetes mellitus and the increased use of probiotics, it is expected that in the future we will see an increase in infections caused by Lactobacilli. Medical management with antibiotics and percutaneous drainage were successful strategies for the treatment of this unusual case of pyogenic liver abscesses and bacteremia caused by Lactobacillus gasseri.
乳杆菌属是革兰氏阳性非孢子形成的杆菌，通常存在于口腔、胃肠道和女性生殖道的微生物群中。此外，它们还常用于食品工业作为补充剂和益生菌。通常认为乳杆菌对人体无致病性，但在某些情况下，如免疫抑制，它们会引起严重感染，仅有少数菌血症、感染性心内膜炎、肺炎、脑膜炎和腹腔内感染的病例报告。在这些表现中，化脓性肝脓肿较为罕见。
我们描述了一例 59 岁男性的病例，该男性患有糖尿病和多次腹部手术，最近一次手术是在 2014 年，因格氏乳杆菌引起菌血症和多个大化脓性肝脓肿，似乎与使用益生菌或免疫抑制无关。
鉴于糖尿病的高患病率和益生菌的使用增加，预计未来我们将看到更多由乳杆菌引起的感染。抗生素和经皮引流的医学治疗是治疗这种由格氏乳杆菌引起的化脓性肝脓肿和菌血症的罕见病例的成功策略。
