Lactobacillus Endocarditis Complicated by Presumed Vertebral Osteomyelitis and Embolic Stroke

Abstract

Abstract Lactobacillus species is a facultative anaerobic gram-positive bacillus that is part of the normal flora and is rarely considered pathogenic. In fact, frequently it is used therapeutically as a probiotic. Although normally considered benign, Lactobacillus has been reported to cause bacteremia with and without endocarditis, vertebral osteomyelitis, abscesses, meningitis, peritonitis, and pneumonia. Recommended treatment of choice based on expert opinion for severe infections due to Lactobacillus species endocarditis is high-dose penicillin in combination with an aminoglycoside. In this report, we describe a case in which a 47-year old man with no past medical history develops native aortic valve endocarditis complicated by embolic stroke and presumed lumbar vertebral osteomyelitis.