Symbiotic Bacteria Induced Necrotizing Pancreatitis
Abstract
Context Intestinal flora and anaerobes are frequently implicated in causing infectious necrotizing pancreatitis however Bifidobacterium and Veillonella have rarely been isolated as the causative agents. Bifidobacterium and Veillonella are commensal anaerobes which reside in gastrointestinal tract and help deconjugate bile acids. Bifidobacterium is also frequently used in probiotics. Case report We present a 68-year-old man who initially presented with gallstone pancreatitis but eventually developed Bifidobacterium and Veillonella species induced necrotizing pancreatitis and pseudocyst formation. Conclusion Under rare circumstances commensal gut flora can turn pathogenic which can lead to life-threatening morbidity and may even result in mortality.
Image: Necrotizing pancreatitis with air-fluid levels.
Downloads
References
Tabata M, Nakayama F. Bacteria and gallstones. Etiological significance. Dig Dis Sci 1981; 26:218-24. [PMID 7238247]
Brook I, Frazier EH. Microbiological analysis of pancreatic abscess. Clin Infect Dis 1996; 22:384-5. [PMID 8838210]
Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006; 101:2379-400. [PMID 17032204]
Ohishi A, Takahashi S, Ito Y, Ohishi Y, Tsukamoto K, Nanba Y, et al. Bifidobacterium septicemia associated with postoperative probiotic therapy in a neonate with omphalocele. J Pediatr 2010; 156:679-81. [PMID 20303445]
Civen R, Väisänen ML, Finegold SM. Peritonsillar abscess, retropharyngeal abscess, mediastinitis, and nonclostridial anaerobic myonecrosis: a case report. Clin Infect Dis 1993; 16:S299-303. [PMID 8324135]
Cryan B, Azadian BS, Dunwoody GW, Richards PG. Epidural abscess due to Streptococcus milleri and Bifidobacterium species. J Infect 1991; 23:214-5. [PMID 1753128]
Green SL. Case report: fatal anaerobic pulmonary infection due to Bifidobacterium eriksonii. Postgrad Med 1978; 63:187-8. [PMID 628649]
Besselink MG, van Santvoort HC, Buskens E, Boermeester MA, van Goor H, Timmerman HM, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 2008; 371:651-9. [PMID 18279948]
Marik PE, Careau P. The role of anaerobes in patients with ventilator-associated pneumonia and aspiration pneumonia: a prospective study. Chest 1999; 115:178-83. [PMID 9925081]
Boo TW, Cryan B, O'Donnell A, Fahy G. Prosthetic valve endocarditis caused by Veillonella parvula. J Infect 2005; 50:81-3. [PMID 15603847]
Brook I. Microbiology of intracranial abscesses associated with sinusitis of odontogenic origin. Ann Otol Rhinol Laryngol 2006; 115:917-20. [PMID 17214267]
Villatoro E, Mulla M, Larvin M. Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis. Cochrane Database Syst Rev 2010; 5:CD002941. [PMID 20464721]
van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med 2010; 362:1491-502. [PMID 20410514]
Copyright (c) 2010 Rajanshu Verma, Radhika Dhamija, Stephen C Ross, Donald H Batts, Mark E Loehrke
This work is licensed under a Creative Commons Attribution 4.0 International License.
As a member of Publisher International Linking Association, PILA, iMedPub Group’s JOP follows the Creative Commons Attribution License and Scholars Open Access publishing policies. Journal of the Pancreas is the Council Contributor Member of Council of Science Editors (CSE) and following the CSE slogan Education, Ethics, and Evidence for Editors.