Lactobacillus Bacteremia: A Tell-tale Sign for Diabetes?

BACKGROUND: Lactobacillus is a commensal that can be found as normal flora in the oropharynx, gastrointestinal and genitourinary tracts. Lactobacillus sepsis and bacteremia is usually found in immunocompromised individuals. In patients with no known underlying disease presenting with lactobacillus bacteremia, an extensive workup should be done before dismissing the organism as a contaminant. CASE: A 35-year-old man with no known past medical history presented with a perianal abscess associated with Lactobacillus bacteremia. There was no known history of human immunodeficiency virus, diabetes mellitus, carcinomas or chemotherapy, intravenous drug abuse, and/or commercial probiotic use. Laboratory testing revealed an HA1c of 15%, leading to a new diagnosis of diabetes mellitus and the initiation of insulin therapy. CONCLUSION: Through this case report, we aim to raise awareness regarding underlying diseases that may be present when a patient presents with Lactobacillus bacteremia. The detection of Lactobacillus bacteremia should always prompt further investigation of its source and ensure clearance to prevent high mortality.