A 70-year-old man in Japan died from a blood infection linked to a probiotic supplement he was taking after recovering from severe COVID-19, according to a recent case report. This tragic incident highlights the potential risks of probiotics, particularly in patients with compromised immune systems.
Doctors at Fujita Health University Hospital in Tokyo detailed the case in BMJ Case Reports. The man had been hospitalized with severe COVID-19 and treated with immunosuppressants, a standard practice for severe cases. After recovering and being discharged from the ICU, he developed diarrhea, likely a side effect of the medication. He was then prescribed a probiotic containing Clostridium butyricum, commonly used in Japan to treat diarrhea.
A month into taking the supplement, the man experienced severe stomach pain. His condition deteriorated rapidly, leading to organ failure and death. Doctors diagnosed him with bacteremia, a blood infection. Genetic testing confirmed the infection was caused by a strain of C. butyricum identical to the one in his probiotic supplement. This marks the first reported case of definitive probiotic-related C. butyricum bacteremia following severe COVID-19 treatment.
Probiotics and the Microbiome
Probiotics aim to restore balance to the gut microbiome. C. butyricum has been studied for its potential in treating recurrent Clostridioides difficile infections and enhancing cancer immunotherapy, as the microbiome is believed to influence treatment response. “While probiotics are routinely prescribed to patients with gastrointestinal issues, rare but severe adverse events can occur, as demonstrated in this report,” the doctors noted.
A History of C. butyricum Infections
This isn’t the first time C. butyricum, typically considered beneficial, has caused harm. It’s a rare cause of botulism. In May 2024, Japanese researchers reported five cases of C. butyricum bacteremia linked to probiotic supplements. Similar to the recent case, most of these patients had weakened immune systems. This suggests the need for greater caution when prescribing probiotics, especially C. butyricum, to immunocompromised individuals.
A Call for Caution
The researchers of the May 2024 study emphasized the risk of bacteremia from probiotic use, particularly in hospitalized patients, advocating for careful prescription practices. This latest case reinforces the need for vigilance and further investigation into the safety of probiotics in vulnerable populations.
Conclusion
This case underscores the importance of careful consideration when prescribing probiotics, particularly for patients recovering from severe illnesses and those with compromised immune systems. While probiotics can offer benefits, their potential risks, especially with C. butyricum, shouldn’t be overlooked. Further research is needed to fully understand the complex interplay between probiotics, the microbiome, and the immune system, enabling safer and more effective probiotic use.
