Purulent Pericarditis Caused by Group G Streptococcus as an Initial Presentation of Colon Cancer

Abstract

Bacterial pericarditis has been recognized as a rare disease since the development of antibiotics. Usually, the disease is associated with underlying conditions or a seeding of infection elsewhere to the pericardium. Here we describe a case of group G streptococcal pericarditis as an initial presentation of colon cancer. A 52-yr-old man was admitted because of dyspnea. An electrocardiogram showed a diffuse ST-segment elevation and a two-dimensional echocardiogram showed a large amount of pericardial effusion. A pericardiocentesis was done and purulent fluid was drained. Group G streptococci was cultured in pericardial fluid. The patient was treated with antibiotics and pericardiostomy with saline irrigation. A colonoscopy revealed a small mass with moderately differentiated adenocarcinoma in rectosigmoid colon. He underwent a mucosectomy and was recovered without any complication.

Bacteria and cancer: cause, coincidence or cure? A review

“…Several species of bacteria have been linked to chronic infections of the colon and increased risk of colon cancer including Escherichia coli [ 46 ] and several streptococci [ 47 , 48 ]. Recent studies, however, have validated earlier findings of an association between colon cancer and Streptococcus bovis [ 11 , 12 ].…”

“…Evidence has shown that over-expression of COX-2 has a major role in mucosal inflammation [ 47 ] and is associated with inhibition of apoptosis [ 54 ] and enhancement of angiogenesis [ 55 ], which favor cancer initiation and development. It was reported by Biarc et al [ 11 ] that S. bovis proteins also promoted cell proliferation by triggering mitogen-activated protein kinases (MAPKs), which can increase the incidence of cell transformation, the rate of genetic mutations and up-regulate COX-2.…”

Diagnostic Value of Pericardial Fluid Analyses

“…Anaerobic infection of the pericardium can result from (1) a spread from a contiguous focus of infection, either de novo or after surgery or trauma (pleuropulmonary, esophageal fistula or perforation, and odontogenic); (2) a spread from a focus of infection within the heart, most commonly from endocarditis; (3) a hematogenous infection, and (4) a direct inoculation as a result of a penetrating injury or cardiothoracic surgery [95,96].…”

Mikroorganismoek minbizia eragin dezakete?

“…[25,26], Escherichia coli [27] eta Streptoccocus spp. [28,29]. Bakterio horiek erabilitako mekanismoak oso ezagunak izan ez arren, Streptococcus bovis bakterioaren kasuan bere paretako proteinak koloneko minbiziaren garapena azkartzeko gai direla frogatuta dago [30].…”