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Published on: November 16, 2016
Infective Endocarditis in Disseminated Streptococcus dysgalactiae Infection Originating From Hitherto Undetected
Roel Meeus1, Lander Bacquaert1, Filip Baert1
1Department of Gastro-Enterology, AZ Delta, Roeselare, Belgium.
None:
A 60-year-old woman presented with polyarthritis in the aftermath of an upper respiratory tract infection. Further investigation revealed infective mitral valve endocarditis necessitating acute surgical valve replacement due to Streptococcus dysgalactiae, as evidenced by positive blood and intraoperative cultures, with disseminated infection and septic emboli in kidneys, multiple joints, and brain. Subsequent colonoscopy revealed a hitherto undetected rectal adenocarcinoma. The co-occurrence of S. dysgalactiae endocarditis and colorectal malignancy in this patient, who was within the age range of elevated baseline risk, may represent coincidental coexistence rather than a causal relationship. This case adds to the sparse literature linking S. dysgalactiae infection with colorectal neoplasia and suggests that colonoscopy may be considered on an individualized, risk-adapted basis in selected patients with S. dysgalactiae endocarditis-an approach distinct from the evidence-based colonoscopy recommendations applicable to Streptococcus gallolyticus endocarditis.
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