An unlucky chain of events seems to have resulted in a man’s death from probiotics. In a recent case report, doctors in Japan detail how the man developed a fatal blood infection caused by a popular supplement he had been taking to help with his recovery from covid-19.
Doctors from Fujita Health University Hospital in Tokyo relayed the bizarre tale in a paper published earlier this month in BMJ Case Reports, which involved a man in his 70s.
The man had been admitted to an intensive care unit with a severe bout of covid-19. He was given drugs to dampen his immune system, which are routinely used for severe COVID cases. He recovered and was eventually discharged from the ICU. The drugs may have caused the man to have diarrhea, however. So he was prescribed a probiotic supplement containing the bacterium Clostridium butyricum, a “widely used” treatment for diarrhea in Japan, according to the doctors. He had been taking the supplement for a month when he started having severe stomach pain. Despite his doctors’ efforts, the man’s condition quickly worsened as his organs began to fail and he soon died.
The doctors found that the man had developed bacteraemia, or a blood infection. Further testing revealed that the infection was caused by a strain of C. butyricum that was a genetic match to the strain of bacteria isolated from the man’s supplement. As far as the doctors know, this is the first reported “case of definitive probiotics-related C. butyricum [bacteremia ] after treatment of severe COVID-19.”
Probiotics are intended to help balance out a person’s unhealthy microbiome. And C. butyricum in particular has been studied as a potential treatment for recurrent Clostridioides difficile infections and as a booster to cancer immunotherapy (the microbiome is thought to influence a person’s response to the latter). “While probiotics are routinely prescribed [to] ill patients with various gastrointestinal symptoms and conditions, rare yet severe adverse events may occur, as exemplified in this report,” the doctors wrote.
This isn’t the first instance of this normally “good” bacteria causing serious trouble. The bacteria is known to be a rare cause of botulism. And earlier this May, a separate team of researchers in Japan reported five cases of bacteremia traced back to C. butyricum supplements. As with this latest report, most of these cases occurred in people who had weakened immune systems. So at the very least, more care might be needed in giving this and other probiotics to such patients.
“Our findings underscore the risk for bacteremia resulting from probiotic use, especially in hospitalized patients, necessitating judicious prescription practices,” the researchers of the May paper wrote.
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