PDF(Pubmed)
Abstract：
Infective endocarditis (IE) is a life-threatening condition often associated with various complications. A unique subset of IE cases involves the Streptococcus gallolyticus group, which has a well-documented but sometimes poorly understood association with colonic neoplasms. Specifically, colon cancer has a well-established association with IE caused by S. gallolyticus subspecies (spp.) gallolyticus. However, finding colon cancer in cases of IE due to S. gallolyticus spp. pasteurianus is rather unexpected. Herein, we present a rare instance of IE caused by S. gallolyticus spp. pasteurianus in a 62-year-old male, which led to the discovery of an underlying colorectal carcinoma. Considering the overall elevated risk of colon cancer in patients with endocarditis and in patients with S. bovis/S. equinus complex (SBSEC) bacteremia, we decided to proceed to colonoscopy, which revealed adenocarcinoma. The patient was administered a targeted antibiotic regimen and underwent a successful surgical resection, followed by valve replacement surgery. The outcome of this case supports the recommendation of routine colonoscopic evaluation in patients diagnosed with S. gallolyticus bacteremia, including those with subspecies pasteurianus, particularly when there are other associated findings. It strengthens the argument for conducting a colonoscopy in individuals diagnosed with SBSEC endocarditis, while carefully considering the specifics of each clinical situation. Our report highlights the need for heightened clinical vigilance and an integrated approach to treatment in similar cases.
摘要：
感染性心内膜炎（IE）是一种威胁生命的疾病，通常与各种并发症有关。IE病例的一个独特子集涉及胆囊溶血性链球菌组，它与结肠肿瘤有很好的记录，但有时知之甚少。具体来说,结肠癌与由卵溶链球菌亚种（spp。)胆囊。然而,在因卵溶链球菌引起的IE病例中发现结肠癌。巴斯德氏杆菌是相当出乎意料的。在这里，我们介绍了一种罕见的由溶胆虫引起的IE。一名62岁男性的巴氏菌,这导致了潜在的结直肠癌的发现。考虑心内膜炎患者和牛链球菌/S患者的结肠癌总体风险升高。马蹄综合征（SBSEC）菌血症，我们决定进行结肠镜检查,显示腺癌。患者接受了靶向抗生素治疗，并接受了成功的手术切除，其次是瓣膜置换手术。该病例的结果支持对诊断为胆溶菌菌血症的患者进行常规结肠镜检查评估的建议，包括那些有巴氏亚种的人，特别是当有其他相关发现时。它加强了对诊断为SBSEC心内膜炎的个体进行结肠镜检查的论点，同时仔细考虑每种临床情况的细节。我们的报告强调了在类似病例中提高临床警惕性和综合治疗方法的必要性。
