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Jason S. Gold, MD; Sancar Bayar, MD; Ronald R. Salem, MD

Arch Surg. 2004;139:760-765.

Background  The association between Streptococcus bovis bacteremia and colonic neoplasia is well described; however, the relationship between S bovis and neoplasia outside the colon has not been well evaluated.

Hypothesis  S bovis bacteremia may be associated with colonic neoplasia and extracolonic malignancy.

Design  Retrospective review of all documented cases of S bovis bacteremia identified by a search of computerized bacteriology records.

Setting  One tertiary referral hospital and 1 community hospital located in the same city.

Patients  Forty-five patients (41 adults, 4 children) with documented S bovis bacteremia during a 12-year period were identified.

Main Outcome Measures  Available patient records were reviewed to identify the presence of colonic neoplasia, the use of gastrointestinal endoscopy, and the presence of gastrointestinal or extraintestinal malignancies.

Results  Seventeen patients (41% of adult patients) underwent colonoscopy. Colonic neoplasia was present in 16 patients (39% of adults), with 3 of these patients having invasive colorectal cancer (7% of adults). Invasive cancer was present in 13 patients (32% of adults). Eight patients had malignant lesions arising within the gastrointestinal tract, and 5 patients had extraintestinal malignancies.

Conclusion  S bovis bacteremia is associated with both colonic neoplasia and extracolonic malignancy.

From the Department of Surgery, Yale University School of Medicine, New Haven, Conn.

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