Saccharomyces boulardii
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Saccharomyces cerevisiae fungaemia: case report A 3.5-month-old male infant developed Saccharomyces cerevisiae fungaemia while receiving Saccharomyces boulardii as a probiotic to prevent antibiotic-associated diarrhoea. The infant was admitted with history of watery diarrhoea for 3 days. He had 3 episodes of respiratory tract infection since one month of age, which had been treated with oral antibiotics. In order to prevent antibiotic-associated diarrhoea, he had been prescribed probiotic preparation containing Saccharomyces boulardii 250mg twice daily [route not stated] for the 10 days during each episodes. During the current admission, he was malnourished and dehydrated. He developed intermittent fever and erythematous macular skin rashes over the trunk and limbs. His liver was enlarged and there was no splenomegaly. Few discrete palpable lymph nodes were noted in the cervical region. Blood test demonstrated Hb 11.4 g/dL, total WBC count 3400 with 74% neutrophils, mildly raised CRP and normal liver and renal function tests. Chest X-ray showed prominent bronchovascular markings on either side, with a barely discernible thymic shadow. His blood culture grew fungus Saccharomyces cerevisiae [time to reaction onset not stated], which was sensitive to amphotericin B and caspofungin. The infant was then treated with a IV amphotericin B after being shifted to another hospital. Immunological test during this period revealed CD45 absolute 720, CD3 absolute 324, CD4 absolute 137, CD8 absolute 173, CD4/CD8 ratio 0.79, serum IgG total 226 mg/dL, serum IgA total 0.52 mg/dL and serum IgM total less than 10 mg/dL. These findings showed combined T and B cell deficiency. Thereafter, his parents declined any further genetic tests. He was then discharged against medical advice [outcome not stated]. Author comment: "Probiotic treatment with [Saccharomyces boulardii] is reported to cause invasive fungemia by the related subtype [Saccharomyces cerevisiae].""Invasive fungal sepsis by the normally nonpathogenic strains of [Saccharomyces cerevisiae] following therapy with [Saccharomyces boulardii] is being reported increasingly." Chakravarty S, et al. Saccharomyces cerevisiae Sepsis Following Probiotic Therapy in an Infant. Indian Pediatrics 56: 971-972, No. 11, Nov 2019. Available 803443689 from: URL: http://doi.org/10.1007/s13312-019-1655-7 - India
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Reactions 4 Jan 2020 No. 1785
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