ABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/pathogenicity , Liver Abscess/complications , Liver Abscess/diagnosis , Liver Abscess/microbiology , Adenoma, Villous/complications , Adenoma, Villous/diagnosis , Adenoma, Villous/microbiology , Risk Factors , Bile Ducts/pathology , Endoscopy/methods , Colonoscopy/methods , ColonoscopyABSTRACT
OBJECTIVE: We sought to identify possible diseases associated with bloodstream infections caused by new species of S. bovis group isolated in blood cultures and by studying patient records METHODS: Forty-four consecutive blood culture isolates initially designated S. bovis were further characterised using phenotypic methods Patient records were examined. RESULTS: We identified 15 Streptococcus gallolyticus subsp. gallolyticus, 24 Streptococcus gallolyticus subsp. pasteurianus, and 5 Streptococcus infantarius isolates in 44 BSI episodes. CONCLUSIONS: The association between S. bovis bacteraemia and endocarditis and/or colon carcinoma is highly dependent on the causative species. Streptococcus gallolyticus subsp. gallolyticus is a surrogate for endocarditis and/or bowel disease, whereas Streptococcus gallolyticus subsp. pasteurianus is a surrogate for hepato-biliary disease.
Subject(s)
Bacteremia/microbiology , Colonic Neoplasms/microbiology , Endocarditis, Bacterial/microbiology , Intestines/microbiology , Streptococcal Infections/microbiology , Streptococcus bovis/classification , Adenoma, Villous/epidemiology , Adenoma, Villous/etiology , Adenoma, Villous/microbiology , Aged , Aged, 80 and over , Bacteremia/epidemiology , Biliary Tract Diseases/epidemiology , Biliary Tract Diseases/microbiology , Carcinoma, Hepatocellular/epidemiology , Carcinoma, Hepatocellular/microbiology , Causality , Colonic Neoplasms/epidemiology , Colonic Neoplasms/etiology , Colonic Polyps/epidemiology , Colonic Polyps/etiology , Colonic Polyps/microbiology , Comorbidity , Drug Resistance, Multiple, Bacterial , Endocarditis, Bacterial/epidemiology , Female , Heart Valve Diseases/epidemiology , Heart Valve Prosthesis , Humans , Liver Cirrhosis/epidemiology , Liver Cirrhosis/microbiology , Liver Neoplasms/epidemiology , Liver Neoplasms/microbiology , Male , Middle Aged , Phenotype , Prosthesis-Related Infections/epidemiology , Prosthesis-Related Infections/microbiology , Spain/epidemiology , Species Specificity , Streptococcal Infections/epidemiology , Streptococcus bovis/drug effects , Streptococcus bovis/isolation & purification , Streptococcus bovis/pathogenicityABSTRACT
Bacteremia and infectious endocarditis caused by Streptococcus bovis may be related to the presence of inflammation or neoplastic lesions in the large intestine. This report describes a 46-year-old woman who presented with infectious endocarditis caused by S. bovis associated with colonic tubular-villous adenoma. Demonstration of bacterial DNA by polymerase chain reaction and identification by DNA sequencing was performed to establish the diagnosis.
Subject(s)
Adenoma, Villous/microbiology , Colonic Neoplasms/microbiology , Streptococcal Infections/microbiology , Streptococcus bovis , Adenoma, Villous/complications , Adenoma, Villous/diagnosis , Colonic Neoplasms/complications , Colonic Neoplasms/diagnosis , DNA, Bacterial , Female , Humans , Middle Aged , Polymerase Chain Reaction , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Streptococcus bovis/isolation & purificationABSTRACT
BACKGROUND: Many studies in the literature have warned of the need for investigation of colonic lesions among patients, especially elderly ones, who have bacteremia and/or endocarditis from Streptococcus bovis. Bacteremia and infectious endocarditis from Streptococcus bovis may be related to the presence of neoplastic lesions in the large intestine and hepatic disease. AIM: This report describes a patient who presented infectious endocarditis from Streptococcus bovis associated with colonic carcinoma and tubular-villous adenomas. CONCLUSIONS: The finding of this bacterium among patients with septicemia and/or endocarditis is also related to the presence of villous or tubular-villous adenomas in the large intestine. For this reason, complete and detailed investigation of the large intestine must be performed in patients with infectious endocarditis, even in the absence of intestinal symptoms. An increased incidence of this condition or hepatic dysfunction has been reported among patients with infectious endocarditis from Streptococcus bovis. Patients with infectious endocarditis from Streptococcus bovis and normal colonoscopy may be included in the group at risk for developing colonic cancer. The knowledge that there is an association between endocarditis from Streptococcus bovis and carcinoma of the colon has important clinical implications. If the lesion can be discovered at an early stage, curative resection may become possible.