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BMJ Case Reports 2012; doi:10.1136/bcr.06.2011.4412
  • Reminder of important clinical lesson

Saccharomyces boulardii fungemia caused by treatment with a probioticum

  1. Britta Tarp
  1. Department of Internal Medicine, Regionshospitalet Silkeborg, Silkeborg, Denmark
  1. Correspondence to Dr Britta Tarp, brittarp{at}rm.dk

Summary

Saccharomyces cerevisiae, known as baker’s yeast, is normally considered a non-pathogenic yeast. A genetically very similar subtype, S boulardii, is used in a probioticum (Sacchaflor) to prevent antibiotic-associated diarrhoea and in the treatment of recurrent Clostridium difficile associated diarrhoea. The authors present a case report of a 79-year-old woman with rheumatoid arthritis, who after a bowel resection developed S boulardii fungemia. Her postoperative course was complicated by nutritional problems, anaemia and several nosocomial infections including recurrent C difficile associated diarrhoea. The diarrhoea was treated with metronidazole, vancomycin and Sacchaflor. After 13 days of treatment, the patient developed fungemia with S boulardii. Treatment with Sacchaflor was immediately discontinued and the patient was successfully treated with amphotericin B. Fungemia is a rare, but a serious complication to treatment with probiotics. Accordingly, the authors find it important to remind the clinicians of this risk when prescribing probiotics especially to immunocompromised patients.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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