Lactobacillus Rhamnosus Sepsis in an Immunosuppressed Patient with Tuberculous Meningitis and Myeloradiculitis

Sandra Xerinda, Lurdes Sant

Abstract

Portugal has reduced the incidence of tuberculosis disease in last years, but has an incidence that surpasses the average in Europe. The risk of reactivation of latent tuberculosis in patients about to undergo immunosuppressive and immunomodulatory therapy is high, and therefore, screening and treatment is mandatory in order to avoid the evolution of the disease from latent to active, with severe forms often difficult to treat. We report a case of a 37 years old female, previously medicated with prednisolone and mycophenolate mofetil for a bullous pemphigus until the diagnosis of disseminated tuberculosis. In the course of the disease, a central venous catheter was placed for total parenteral nutrition due suspicion of poor absorption of antituberculous drugs. The patient had an endocarditis and septic thrombophlebitis with bacteremia due to Lactobacillus rhamnosus and difficult to treat tuberculosis complicated with meningomyeloradiculitis, which resulted in paraplegia associated with a neurogenic bladder.