Streptococcus bovis infectious endocarditis and occult gastrointestinal neoplasia: experience with 25 consecutive patients treated surgically.

Anthony Alozie,Lumi Pose,Andreas Podbielski,Bernd Westphal,Gustav Steinhoff,Georg Lamprecht,Maximilian Raftis,Kerstin Köller

doi:10.1186/s13099-015-0074-0

Abstract

To assess the prevalence of gastrointestinal neoplasia in patients with Streptococcus bovis infectious endocarditis we performed a retrospective cohort analysis of all episodes of S. bovis infectious endocarditis treated at our institution between January 2000 through December 2014. Twenty-five patients were identified for this purpose. 12/25 patients received colonoscopy and 1/25 of the patients was assessed with CT colonography. Of the 13 who underwent colonic assessment, 11 were diagnosed with colonic neoplasms at different stages of development. In the absence of any strong contraindication, gastroenteroscopic evaluation in all patients diagnosed with S. bovis infectious endocarditis should be pursued.

Highlights

Streptococcus bovis (S. bovis), is a commensal inhabitant of the human digestive tract
Since the first remarkable case of the association between an enterococcal infection and colorectal carcinoma presented by McCoy et al in 1951 and the case control study by Klein et al over two decades later, the association between S. bovis bacteremia and colorectal neoplasia has been thoroughly well established in the literature [2,3,4]
A systematic review of 31 studies published by Boleij et al in 2011 found that 65 % of patients infected by S. bovis, in addition to high levels of infectious endocarditis (IE), were diagnosed with concomitant colorectal neoplasias [7]

Summary

Introduction

Streptococcus bovis (S. bovis), is a commensal inhabitant of the human digestive tract. It may be isolated in up to 35 % of fecal samples from human rectal swab [1]. Since the first remarkable case of the association between an enterococcal infection and colorectal carcinoma presented by McCoy et al in 1951 and the case control study by Klein et al over two decades later, the association between S. bovis bacteremia and colorectal neoplasia has been thoroughly well established in the literature [2,3,4]. A systematic review of 31 studies published by Boleij et al in 2011 found that 65 % of patients infected by S. bovis, in addition to high levels of IE, were diagnosed with concomitant colorectal neoplasias [7].

Methods

Results

Discussion

Conclusion