Background: Lactobacillus is a commensal germ found in the buccal cavity, the digestive tract and the vagina. Usually non-pathogenic except in case of dental caries, it can occasionally be the causal agent in severe endocarditis.
Case report: A 70-year-old woman developed endocarditis on an aortic valve bioprosthesis. Lactobacillus acidophilus was isolated from blood cultures of the valve after surgery.
Comments: Forty-four cases of Lactobacillus endocarditis have been reported in the literature to date. Mortality is high (26%). The main difficulty in treatment is germ tolerance to penicillin and aminosides found in all cases. Cure requires high dose parenteral antibiotics and surgery in many cases (26%).