Lactobacillus
Lactobacillus is a gram positive rod, a normal part of the lower GI tract and the female genital tract. It is a rare cause of serious infections, like endocarditis.
The patient has a history of a Whipple, where the pancrease is removed, and has nothing to do with soft, squeezable toilet paper, 5 years ago. Now he has fever and mid epigastric pain and CT shows an abscess.
It is drained, and both the abscess and the blood grow lactobacillus, as you might have guessed from the title.
It is a curious case. Lactobacillus is also a probiotic (given what they cost, they are certainly not amateur biotics), and there has been the occasional odd case of lactobacillus in the blood and a liver abscess due to lactobacillus. Generally, however, it is thought that probiotic lactobacillus are safe.
I presume the patient has a leak somewhere causing this abscess, but as of today we have not been able to find one.
There are a smattering human cases of lactobacillus abdominal abscess on a pubmed search, both associated with gastric perforation.
Drain and antibiotics, and expect I will cure him as long as he does not have a leak.
And best of all, his immune system is being boosted by the lactobacillus in his peritoneum and blood. I assume he is getting far more immune boosting than if he were taking the probiotic as DanActive. Right?
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Obes Surg. 2006 Jan;16(1):102-4.Click here to read Links
Intra-abdominal abscess in the course of intragastric migration of an adjustable gastric band: a potentially life-threatening complication.
Wylezol M, Sitkiewicz T, Gluck M, Zubik R, Pardela M.
Intragastric band migration is a potential complication of adjustable gastric banding. A 39-year-old morbidly obese female underwent laparoscopic adjustable gastric banding. After uneventful postoperative follow-up of 4 years, she had slow, steady failure of the restrictive effect, associated with regain of weight. Intragastric band migration was confirmed on GI series, and the patient was admitted to the hospital for revision. The patient presented no symptoms of acute abdomen. Intraoperatively, a huge intra-abdominal abscess was discovered in the epigastric area. The stomach with the band and tubing were involved in the inflammatory process. Labtobacillus acidofilus was found to be the causative organism. Removal of the gastric band with simultaneous resectional gastric bypass was performed. The recovery proceeded with no complications. Intragastric band migration can cause intra-abdominal abscess; thus, we believe that every case of band migration should be treated without delay to avoid further complications.
PMID: 16417767
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