Reactions 1267 - 29 Aug 2009

SSaccharomyces boulardii

Gastrointestinal allergic reaction in an infant:case report

An 8-month-old boy with food protein-inducedenterocolitis syndrome (FPIES), developed a GI allergicreaction after receiving lyophilised Saccharomycesboulardii [Bioflor] for presumed bacterial colitis.

The infant received S. boulardii [dosage not stated] andcefixime and, 2 hours later, after taking the medicines, hepresented with cyanosis and repetitive vomiting, requiringIV fluid resuscitation. S. boulardii was presumedresponsible for the FPIES-like allergic reaction.

The infant underwent an oral food challenge (OFC)1 week later, after his bacterial colitis had resolved. Hereceived one pack of Bioflor, containing 282.5mg oflyophilised S. boulardii and 471.9mg of fructose. Hedeveloped projectile vomiting 2 hours later, and lethargyand cyanosis thereafter. He had a BP of 74/39mm Hg. Aninfusion of sodium chloride was initiated, followed bydextrose saline. His BP normalised to 92/65mm Hg after5 hours. Bloody, purulent stools with a foul odour wereobserved 8 hours later. Many RBCs and WBCs wereevident on a stool smear. Clinical findings were consistentwith a GI allergy induced by lyophilised S. boulardii, such asthe FPIES reaction.

Author comment: "On the basis of the OFC and clinicaldiagnostic criteria, the present case demonstrates an FPIES-like allergic reaction caused by S. boulardii."Hwang J-B, et al. Probiotic gastrointestinal allergic reaction caused bySaccharomyces boulardii. Annals of Allergy, Asthma & Immunology 103: 87-88,No. 1, Jul 2009 - South Korea 801150221

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Reactions 29 Aug 2009 No. 12670114-9954/10/1267-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved