Infective endocarditis caused byStreptococcus gallolyticussubspeciespasteurianusand colon cancer

Abstract

SUMMARYA 56-year-old man presented to our department with a 2-month history of fever and chills. He had received a mitral valvuloplasty 3 years ago. He had been administered levofloxacin for 2 months. We discontinued levofloxacin and repeated the blood cultures. Bacterial blood cultures were positive and transoesophageal echocardiography revealed vegetation attached to the posterior mitral leaflet. We started the patient on intravenous antibiotic therapy for infectious endocarditis by Streptococcus gallolyticus subspecies pasteurianus. A colonoscopic screening revealed adenomatoid intracellular carcinoma. Previous studies have reported a weak association between colorectal cancer and Streptococcus bovis biotype II/2, which includes S gallolyticus subspecies pasteurianus; however, the rate is notably higher than the rate of colorectal cancer as indicated by positive faecal occult-blood test results. We conclude that colonoscopies should be routine while scanning for colorectal cancer in all patients with S bovis bacteraemia, regardless of the subspecies. BACKGROUND

A Microbiomic Analysis in African Americans with Colonic Lesions Reveals Streptococcus sp.VT162 as a Marker of Neoplastic Transformation

“…As such, the Streptococcus gradual prevalence in both adenoma stool samples and colon cancer tissues seems to be a firm finding from the above results. Indeed, several reports have cited an association of Streptococcus strains with colon cancer occurrence [ 59 , 60 , 61 , 62 ]. Streptococcus bacterial strains are known as a large and dynamic component of the small intestine [ 63 ].…”

Inducible Expression of both ermB and ermT Conferred High Macrolide Resistance in Streptococcus gallolyticus subsp. pasteurianus Isolates in China

“…In humans, it is increasingly recognized as a cause of infant meningitis and bacteremia [9,10,11,12], and 58.7% of mortality rate has been observed with one-year neonates relating to this subspecies [13]. In adults, it is linked to a wide spectrum of diseases, including meningitis [14], endocarditis [15,16,17], splenic abscess [18], biliary and urinary tract infection [15,19,20,21], as well as gastric, pancreatic, hepatobiliary and colorectal cancers [16,22]. Death cases in adults were also reported in association with infections by this subspecies.…”

The Association ofStreptococcus gallolyticusSubspeciespasteurianusBacteremia with the Detection of Premalignant and Malignant Colonic Lesions

“…gallolyticus subsp. gallolyticus bacteremia was 94% and 71% with clinical infectious endocarditis and underlying colonic malignancy, respectively [ 11 ]. However, S .…”

“…gallolyticus subsp. pasteurianus bacteremia is less commonly associated with infective endocarditis and occult colonic malignancy at rates of 18% and 17%, respectively [ 11 ]. Regardless of the weaker association of S .…”