Group G streptococcal bacteremia caused by an asymptomatic esophageal carcinoma in an elderly man

I describe the case of a 70-year-old man with group G streptococcal bacteremia, anemia, and stools positive for occult blood in whom no clear source of infection was found until an asymptomatic esophageal carcinoma was diagnosed. Group G bacteremia has been associated with neoplastic sources. Although this patient was asymptomatic--even after a retrospective review of symptoms--endoscopy would still have been done because the stools were positive for occult blood. However, it is well known that bleeding from cancers is often intermittent and that stools may have to be tested on multiple occasions before bleeding is seen. This case supports the association of group G streptococcus and malignancy and suggests that patients with streptococcal group G bacteremia of no obvious source should have a workup for occult malignancy even in the absence of other indications.