A Case of Sepsis
Source: Fredenucci I, et al. Clin Infect Dis 1998;27:222-223.
Ultra-levure (laboratorie bio-CODEX, France) is a biotherapeutic supplement containing Saccharomyces boulardii that is used in Europe to aid digestion and to preserve intestinal flora in patients receiving antimicrobial therapy (levure means yeast in French). An unusual case of S. boulardii sepsis occurred in a previously healthy middle-aged man hospitalized for aspiration pneumonia. The patient received antimicrobials and corticosteroids, but within four days developed severe diarrhea, which was treated with enterally administered Ultra-levure. Four days later he developed fever and fungemia. Pulse field gel electrophoresis of the patient's strains and the strains recovered from levure packets showed similar electrophoretic patterns, which differed from two S. cerevisiae strains, confirming the Ultra-levure as the source of this man's infection.
Like S. cerevisiae, this typically non-pathogenic yeast can rarely result in clinical disease in a relatively normal host. This case reminds us of a similar one reported about 20 years ago: A young man presented with recurrent FUO. Investigation revealed that he often ingested large amounts of brewer's yeast for digestive purposes. His FUO resolved when he stopped ingesting yeast.
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