Persistent Lactobacillus casei subspecies rhamnosus bacteremia in a girl with acute myeloid leukemia - a case report

The present clinical observation is related to a 14-year-old girl suffering from acute myeloid leukemia. The clinical course was complicated by episod es of severe enterocolitis. E coli- septicemia, pancreatitis and pneumonia. In the course of continued cytostatic and antibiotic treatment a persisten t asymptomatic Lactobacillus casei subsp. rhamnosus-bacteremia became detec table by a total of 18 blood cultures. Microbial cultures of the faeces revealed colony-forming unites of this ger m in orders of 10(9)/g. Antibiotic eradication attempts according to the re sistogram were not successful. The Lactobacillus-bacteremia disappeared onl y after 13 months when the cytostatic therapy was terminated. An adjuvant i nfluence of the Lactobacillus infection on the outcome of the underlying di sease can not be excluded.