Lactobacillus species is a known commensal of the mouth, gastrointestinal, and genitourinary tract. However, its isolation on blood cultures is often overlooked and attributed to bench contamination. We present a case of a 58-year-old immunocompetent male who initially presented with altered mental status, but developed sepsis from Lactobacillus bacteremia during his hospital course, while on mechanical ventilation. He was found to have ischemic colitis on colonoscopy. His condition improved with antibiotics and supportive management. Using this example of ischemic colitis, we stress that in the right clinical setting, Lactobacillus bacteremia is a harbinger for a serious underlying pathology and should not be ignored.
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