Streptococcus bovis endocarditis, a silent sign for colonic tumour

Abstract

Streptococcus bovis endocarditis and/or bacteraemia is an early clue to the likely presence of colorectal cancer. Whilst further studies are required to determine the precise pathophysiology, clinicians should be aware of this association. It is advisable to investigate rigorously for colon cancer in all patients presenting with S. bovis endocarditis/bacteraemia; such patients may also present with liver disease or, occasionally, extra-colonic malignancy.

Coloncancer in a patient with underlying aplastic anemia: A clinical challenge

“…Moreover, recurrent infections may occur in both CRC and aplastic anemia. Streptoccocusbovis septicemia is classically associated with colorectal cancer [11] ; other organisms include Enterobacter [12] and Clostridium species [13] . Infections that are seen in aplastic anemia also include Streptoccocus and Clostridium species, in addition to Escherichia coli and others [14] .…”

Streptococcus bovis/gallolyticus Induce the Development of Colorectal Cancer

“…The remarkable association between adenomatous polyps and S. bovis/gallolyticus seems to be of importance due to the compelling evidence that colon cancer progresses from normal tissue to adenoma and then to carcinoma through an accumulation of genetic alterations (Baron & Sandler, 2000). Although ulceration of the neoplastic lesion might form a pathway for the S. bovis/gallolyticus to enter the bloodstream (Gupta et al, 2009), the association of S. bovis/gallolyticus bacteremia with non-ulcerated colonic polyps indicates an etiological/promoter role of these bacteria in polyps progression (Cutait et al, 1988;Konda & Duffy, 2008). The possibility of S. bovis/gallolyticus to act as a promoter for the preneoplastic lesions is worthy to be considered.…”

“…However, the extent, nature, and basis of this association are still not completely understood. S. bovis/gallolyticus became important in human health since it was shown that 25 to 80% of patients who presented S. bovis/gallolyticus bacteremia had also a colorectal tumor and the incidence of association of colonic neoplasia with S. bovis/gallolyticus endocaditis was shown to be 18 to 62% (Gupta et al, 2009;Kok et al, 2007;Leport et al, 1987;Malkin et al, 2008;Murray & Roberts, 1978;Reynolds et al, 1983;Wilson et al, 1981;Zarkin et al, 1990). The knowledge that there is an association between endocarditis from S. bovis/gallolyticus and carcinoma of the colon has important clinical implications (Boleij et al, 2009a;Kok et al, 2007).…”

“…The possible reason behind that, maybe, S. bovis/gallolyticus is a member of intestinal flora in 2.5 to 15% of individuals which usually make scientists counteract any malicious role of this bacteria (Burns et al, 1985;Murray & Roberts, 1978). It was conceived in the beginning that the ulceration of neoplastic lesions might form a pathway for the microorganism to enter the bloodstream (Gupta et al, 2009). However, the latter scenario of bacterial access into the circulation does not explain the cases of patients with infectious endocarditis and non-ulcerated colonic polyps (Cutait et al, 1988).…”

“…One of the bacterial agents that have been most associated with cancer is Streptococcus bovis (S. bovis). S. bovis has been shown to be important in human health because 25 to 80% of patients with S. bovis bacteremia had also colorectal tumor, and the incidence of association of colonic neoplasia with S. bovis endocarditis was shown to be 18 to 62% (Gupta et al, 2009;Kok et al, 2007;Leport et al, 1987;Malkin et al, 2008;Reynolds et al, 1983;Wilson et al, 1981;Zarkin et al, 1990). Later, it was shown that a new species resembling S. bovis is actually most implicated in CRC development; S. bovis infecting human intestine has been named as S. gallolyticus (Osawa et al, 1995).…”