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Streptococcus bovis bacteraemia requires rigorous exclusion of colonic neoplasia and endocarditis
Insights
Streptococcus bovis bacteraemia often indicates serious underlying conditions. Prompt investigation is crucial for detecting endocarditis and colorectal tumors.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Cardiology
Background:
- Streptococcus bovis is a bacterium known to cause infections in humans.
- Bacteraemia, the presence of bacteria in the bloodstream, can lead to severe health complications.
Observation:
- A study reviewed twelve patients with Streptococcus bovis bacteraemia.
- Ten patients had endocarditis, with involvement of prosthetic or native valves.
- Nine patients underwent large bowel investigations, revealing colorectal tumors in eight.
Findings:
- Colorectal tumors, including adenocarcinoma and villous adenoma, were frequently associated with S. bovis bacteraemia.
- Colonoscopy proved effective in diagnosing colorectal neoplasia, even when radiological studies were negative.
- One case highlighted the link between S. bovis bacteraemia, alcoholic cirrhosis, and colonic adenomata.
Implications:
- S. bovis bacteraemia necessitates thorough investigation for both endocarditis and colorectal malignancies.
- Early detection through diagnostic procedures like colonoscopy is vital for patient outcomes.
- This highlights the importance of a multidisciplinary approach in managing patients with S. bovis infections.
Abstract:
Twelve patients presented to the hospitals of the Auckland Hospital Board with bacteraemia caused by Streptococcus bovis in the years 1979-84. Ten had endocarditis, affecting homograft valves in two cases and the tricuspid valve in one case. Of nine patients who underwent investigation of the large bowel, only one did not have a colorectal tumour. Three had colonic adenocarcinoma and three had colorectal villous adenoma. Two, including a patient with acute hepatic failure from alcoholic cirrhosis, had colonic adenomata. Colonoscopy provided a tissue diagnosis of colorectal neoplasia despite negative radiological studies in three patients. Bacteraemia due to S. bovis should prompt rigorous investigation to exclude both endocarditis and tumours of the large bowel.