LACTOBACILLUS BACTEREMIA - DESCRIPTION OF THE CLINICAL COURSE IN ADULT PATIENTS WITHOUT ENDOCARDITIS

Lactobacillus bacteremia in the absence of endocarditis is a rare enti ty, and the clinical relevance of such bacteremia remains unclear. The clinical courses of lactobacillus bacteremia without endocarditis in 43 previously described patients and 12 new patients were reviewed. Ba cteremia with Lactobacillus alone occurred in 34 (62%) of the patients , and 12 (22%) of the patients had bacteremia with other organisms, in cluding Lactobacillus. Lactobacillus was isolated from another site in 18 (33%) of these patients. Intravenous catheter infections were not noted in these patients. Underlying conditions included cancer (6 pati ents), organ transplantation (9), diabetes mellitus (4), and recent su rgery (12). Fever occurred in all patients, and eight (15%) of the pat ients experienced a sepsis syndrome. The mortality rate was 14%; howev er, only three deaths were attributed soley to lactobacillus sepsis. L actobacillus bacteremia is an uncommon condition that usually occurs i n patients with severe underlying illnesses and is frequently seen as a part of a polymicrobial infection. Blood cultures positive for Lacto bacillus represent true infection and not contamination. Although resi stance to commonly used antibiotics is common, the mortality rate asso ciated with this bacteremia appears to be low.