{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:04:06Z","timestamp":1773410646352,"version":"3.50.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infective endocarditis caused by Lactobacillus rhamnosus is extremely rare, particularly in immunocompetent patients without structural heart disease or recent invasive procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 42-year-old immunocompetent man with no structural heart disease or recent interventions presented with fever and dyspnoea. Blood cultures grew L. rhamnosus. Transoesophageal echocardiography revealed a large vegetation on the aortic valve causing severe regurgitation, along with severe mitral regurgitation due to anterior leaflet perforation. The only identifiable risk factor was regular probiotic consumption. The patient underwent successful double valve replacement and completed 6 weeks of antibiotic therapy with favourable outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>A literature review identified 22 published cases of L. rhamnosus endocarditis. Most were associated with underlying valvular disease, invasive procedures, or probiotic use. This case highlights the need to consider Lactobacillus spp. as a potential pathogen, not merely a contaminant, in the appropriate clinical context, and calls for careful patient selection and monitoring when prescribing probiotics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf645","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:13:18Z","timestamp":1765372398000},"source":"Crossref","is-referenced-by-count":1,"title":["Infective endocarditis caused by\n                    <i>Lactobacillus rhamnosus<\/i>\n                    in an immunocompetent patient without structural heart disease or invasive procedures: case report and literature review"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5530-5600","authenticated-orcid":false,"given":"Jos\u00e9 Alejandro","family":"Claros Ruiz","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Regional Universitario de 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Carlos Haya, 84, M\u00e1laga 29010 ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Jos\u00e9","family":"Plata Ciezar","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Regional Universitario de M\u00e1laga , Av. de Carlos Haya, 84, M\u00e1laga 29010 ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"2025122304315496800_ytaf645-B1","first-page":"700","article-title":"2023 Duke-ISCVID criteria for infective endocarditis: a proposal for clinical adoption","volume":"77","author":"Murdoch","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2025122304315496800_ytaf645-B2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0163-4453(86)93733-3","article-title":"Lactobacillus endocarditis","volume":"12","author":"Davies","year":"1986","journal-title":"J 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