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Infected pancreatic necrosis and retroperitoneal abscess associated with Lactobacillus paracasei
  1. Toshiki Miwa,
  2. Hajime Tanaka and
  3. Toshiaki Shiojiri
  1. General internal medicine, Asahi General Hospital, Asahi, Chiba, Japan
  1. Correspondence to Dr Toshiki Miwa; toshiki.miwa1993{at}


Infected pancreatic necrosis is a postpancreatitis complication that is mainly caused by Enterobacteriaceae and Enterococci. Here, we have reported a very rare case of Lactobacillus paracasei bacteraemia associated with infected pancreatic necrosis and retroperitoneal abscess. In addition to the diagnosis of diabetic ketoacidosis, blood test results revealed a high inflammatory status. CT of the abdomen revealed pancreatic walled-off necrosis. Blood culture and aspiration fluid culture revealed positivity for L. paracasei, leading to the diagnosis of infected pancreatic necrosis. The abscess had spread in the retroperitoneal space later. The patient recovered after receiving antibiotic treatment and endoscopic and percutaneous drainage. L. paracasei can cause invasive infection, including infected pancreatic necrosis and retroperitoneal abscess, which requires aggressive therapy.

  • pancreas and biliary tract
  • infectious diseases

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  • Contributors TM and TS conceived the idea of reporting our case. TM and HT contributed to the acquisition and analysis of data. TM wrote the manuscript. HT and TS revised the report critically. All authors approved the final version of the report. TS supervised the project.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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