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Colon Carcinoma Presenting as Streptococcus anginosus Bacteremia and Liver Abscess
Prashanth Rawla1, Anantha R Vellipuram2, Sathyajit S Bandaru3
1Department of Internal Medicine, Memorial Hospital of Martinsville and Henry County, VA, USA.
Abstract:
A collection of dead white blood cells within the liver is called a liver abscess, and pyogenic liver abscess (PLA) is the most common type. PLA is commonly associated with biliary tract infections. However, in this case report, we present a rare cause of Streptococcus anginosus bacteremia and PLA which is associated with a carcinoma of the colon at the splenic flexure. The presentation mimicked a cholecystitis clinically, but the radio-imaging revealed a liver abscess. Blood cultures revealed an uncommon etiological agent, S. anginosus group which is otherwise a commensal in the human gut. In this case report, we aimed to summarize the microbiological aspects of S. anginosus group of organisms, the relevant clinicopathological considerations and the management.
Insights
This case report details a rare instance of Streptococcus anginosus bacteremia leading to a pyogenic liver abscess (PLA). The infection originated from a colon carcinoma, mimicking gallbladder inflammation.
Area of Science:
- Microbiology
- Hepatology
- Gastroenterology
Background:
- Pyogenic liver abscess (PLA) is typically linked to biliary tract infections.
- Streptococcus anginosus is a common gut commensal but an uncommon cause of PLA.
Observation:
- A patient presented with symptoms mimicking cholecystitis.
- Radio-imaging confirmed a liver abscess.
- Blood cultures identified Streptococcus anginosus as the etiological agent.
Findings:
- This case highlights a rare association between colon carcinoma and Streptococcus anginosus bacteremia.
- The splenic flexure carcinoma was the underlying source of infection.
- The clinical presentation initially suggested a biliary origin.
Implications:
- This case underscores the importance of considering unusual sources for PLA.
- It emphasizes the need for thorough investigation when Streptococcus anginosus is identified.
- Early diagnosis and management are crucial for favorable outcomes in rare PLA cases.
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