TY - JOUR
T1 - Severe oral infection due to Lactobacillus rhamnosus during induction chemotherapy for acute myeloid leukemia
AU - Ishihara, Yuko
AU - Kanda, Junya
AU - Tanaka, Kaori
AU - Nakano, Hirofumi
AU - Ugai, Tomotaka
AU - Wada, Hidenori
AU - Yamasaki, Ryoko
AU - Kawamura, Koji
AU - Sakamoto, Kana
AU - Ashizawa, Masahiro
AU - Sato, Miki
AU - Terasako-Saito, Kiriko
AU - Kimura, Shun ichi
AU - Kikuchi, Misato
AU - Nakasone, Hideki
AU - Yamazaki, Rie
AU - Kako, Shinichi
AU - Nishida, Junji
AU - Watanabe, Kunitomo
AU - Kanda, Yoshinobu
N1 - Publisher Copyright:
© 2014, The Japanese Society of Hematology.
PY - 2014/12/6
Y1 - 2014/12/6
N2 - We report a case of severe oral infection with a high fever due to Lactobacillus rhamnosus during induction chemotherapy for acute myeloid leukemia. The patient did not improve on treatment with meropenem, clindamycin, or vancomycin until neutrophil recovery. Since L. rhamnosus GG is used in dairy products, and the patient ingested dairy products daily before starting chemotherapy, we suspected an association between the ingestion of dairy products and the development of infection. Pulsed-field gel electrophoresis using two different restriction enzymes showed that the strain isolated from the patient was identical to the L. rhamnosus GG strain isolated from dairy products and ATCC #53103. This was confirmed by a PCR assay with species-specific L. rhamnosus GG primers. Since Lactobacillus infection, particularly L. rhamnosus infection, can be fatal in immunocompromised hosts, we should consider Lactobacillus as a causative organism when Gram-positive rods are detected during treatment with broad-spectrum antibiotics and vancomycin. The causal association between the ingestion of dairy products containing Lactobacillus and Lactobacillus infection in immunocompromised hosts warrants further study.
AB - We report a case of severe oral infection with a high fever due to Lactobacillus rhamnosus during induction chemotherapy for acute myeloid leukemia. The patient did not improve on treatment with meropenem, clindamycin, or vancomycin until neutrophil recovery. Since L. rhamnosus GG is used in dairy products, and the patient ingested dairy products daily before starting chemotherapy, we suspected an association between the ingestion of dairy products and the development of infection. Pulsed-field gel electrophoresis using two different restriction enzymes showed that the strain isolated from the patient was identical to the L. rhamnosus GG strain isolated from dairy products and ATCC #53103. This was confirmed by a PCR assay with species-specific L. rhamnosus GG primers. Since Lactobacillus infection, particularly L. rhamnosus infection, can be fatal in immunocompromised hosts, we should consider Lactobacillus as a causative organism when Gram-positive rods are detected during treatment with broad-spectrum antibiotics and vancomycin. The causal association between the ingestion of dairy products containing Lactobacillus and Lactobacillus infection in immunocompromised hosts warrants further study.
KW - Acute myeloid leukemia
KW - Lactobacillus rhamnosus
KW - Neutropenic fever
KW - Oral infection
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U2 - 10.1007/s12185-014-1650-7
DO - 10.1007/s12185-014-1650-7
M3 - Article
C2 - 25115834
AN - SCOPUS:84916593867
SN - 0925-5710
VL - 100
SP - 607
EP - 610
JO - International journal of hematology
JF - International journal of hematology
IS - 6
ER -