Streptococcus bovis bacteremia and underlying gastrointestinal disease

Area of Science:

• Medical Microbiology
• Gastroenterology
• Infectious Diseases

Background:

• Streptococcus bovis is a normal inhabitant of the human intestinal tract.
• S bovis bacteremia has been associated with endocarditis and gastrointestinal lesions.
• The precise portal of entry for S bovis bacteremia is not always clear.

Purpose of the Study:

• To investigate the potential gastrointestinal sources of Streptococcus bovis bacteremia.
• To determine the association between S bovis bacteremia and gastrointestinal lesions, including malignancies.
• To assess the clinical significance of S bovis bacteremia as an early indicator of gastrointestinal disease.

Main Methods:

• Retrospective study of 36 adult patients with S bovis endocarditis or bacteremia alone.
• Review of patient histories, clinical findings, and diagnostic procedures, including gastrointestinal evaluations.
• Identification of gastrointestinal lesions or manipulations in patients with S bovis bacteremia.

Main Results:

• Twenty-five of 36 patients had gastrointestinal lesions or manipulation.
• The gastrointestinal tract was identified as the source of S bovis bacteremia in 22 patients.
• Four patients presented with S bovis bacteremia and subsequently diagnosed with colon carcinoma (two) or villous adenomas (two); none had prior bowel symptoms.

Conclusions:

• S bovis bacteremia frequently originates from the gastrointestinal tract and may be associated with significant bowel pathology.
• S bovis bacteremia can serve as an early diagnostic clue for serious, unexpected gastrointestinal diseases, including colorectal cancer.
• Comprehensive gastrointestinal evaluation is recommended for all patients with S bovis bacteremia, irrespective of the presence of endocarditis.