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Probiotic Risks/Immunocompromised Case
  Probiotic Safety and Risk Factors......

"there are risks, particularly in immunocompromised patients."
In this issue, a case report has been published in which a 17-year-old with universal ulcerative colitis treated with both corticosteroids and antibiotics was given Lactobacillus rhamnosus GG by his parents.3 The authors carefully identified a case of sepsis. They identified, genetically and by culture, that the circulating organism was the same as from the probiotic Culturelle. The patient responded to antibiotic therapy, but there was some clinical question as to whether the septic symptoms could have been from a viral infection. The virus was identified before and after manifestation of symptoms. This case was reported as an immunocompromised patient and that appears to be a risk factor status for infection with probiotics, although the incidence is extremely low.4 As noted in our recent book "Probiotics: A Clinical Guide," there are risk factors for possible infection that should be observed before probiotics are administered.5 The risk factors are clearly outlined by Boyle et al.6 Major risk factors are immunocompromised and premature infant patients."
Lactobacillus Bacteremia Associated With Probiotic Use in a Pediatric Patient With Ulcerative Colitis.....http://www.natap.org/2013/HIV/060513_03.htm
This case should alert the reader to the possible danger of seemingly benign over-the-counter medications in UC and the need for proper communication between patients and their physicians. Although it has been proposed that probiotics can provide potential benefits in certain conditions, risks and benefits should still be carefully assessed before initiating this therapy in patients with UC, especially when they have severely active disease and may be immunocompromised."
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