Colonoscopy is mandatory after <it>Streptococcus bovis </it>endocarditis: a lesson still not learned. Case report

• Main Authors: Cavazzi Emma, Dominioni Tommaso, Bombelli Elisa, Botrugno Ivan, Ferrari Alberta, Dionigi Paolo
• Format: Article
• Language: English
• Published: BMC 2008-05-01
• Series: World Journal of Surgical Oncology
• Online Access: http://www.wjso.com/content/6/1/49

<p>Abstract</p> <p>Background</p> <p>Even though the relationship between certain bacterial infections and neoplastic lesions of the colon is well-recognized, this knowledge has not been sufficiently translated into routine practice yet.</p> <p>Case presentation</p> <p>We describe the case of a 51-year-old man who was admitted to our Surgical Department due to rectal bleeding and abdominal pain. Preoperative colonoscopy, staging exams and subsequent surgery demonstrated a stenotic adenocarcinoma of the sigmoid colon, invading the left urinary tract and the homolateral bladder wall, with regional lymph nodes involvement and massive bilobar liver metastases (T4N1M1). After Hartmann's rectosigmoidectomy and despite systemic chemotherapy, a rapid progression occurred and the patient survived for only 5 months after diagnosis. Five years before detecting this advanced colonic cancer, the patient underwent aortic valve replacement due to a severe <it>Streptococcus bovis </it>endocarditis. Subsequent to this infection he never underwent a colonoscopy until overt intestinal symptoms appeared.</p> <p>Conclusion</p> <p>As this case illustrates, in the unusual setting of a <it>Streptococcus bovis </it>infection, it is necessary to timely and carefully rule out occult colon cancer and other malignancies during hospitalization and, if a tumor is not found, to schedule endoscopic follow-up. Rigorous application of these recommendations in the case described would have likely led to an earlier diagnosis of cancer and maybe saved the patient's life.</p>