HomeArchiveVolume 3Volume 3, issue 2A case of silent colonic lesions associated with streptococcus gallolyticus, bacteremia and endocarditis
Nicolae Berevoescu1,2, Adrian Bordea1,2, Răzvan Scăunașu1,2, Mihaela Berevoescu3, Daniel Cristian1,2
1Colțea Clinical Hospital, Department of General Surgery, Bucharest, Romania
2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
3Craiova University of Medicine and Pharmacy, Dolj, Romania
Abstract

We present a clinical case of synchronous colonic lesions, histologically different, associated with streptococcus gallolyticus subsp. gallolyticus (Sgg)/ Streptococcus bovis biotype I, bacteremia and infective endocarditis. A 53-year-old female, without history of CRC in her family, known with total hysterectomy for uterine fibromatosis, presents to Emergency Department for marked asthenia, nausea, weight loss (10 kgs in the last month), febrile episode associated with severe anemia, symptomatology that has increased in the last two weeks. The patient was admitted in the Internal Medicine Department for further investigations, under the suspicion of sepsis of unknown cause. On blood cultures grew Sgg bacteria. Both transthoracic echocardiography and transesophageal echocardiography were performed and diagnosed infective endocarditis with vegetations of the mitral and aortic valves. Antibiotics treatment was initiated, with ceftriaxone and gentamycin, according to antibiogram results. Severe hypochromic, microcytic anemia, and lack of an infective origin site required digestive endoscopic evaluation, and showed gastritis, ulcerovegetative tumor of the ascending colon and polyp in the rectosigmoid. Resection of rectosigmoid polyp was performed through colonoscopy, and, also, right hemicolectomy with ileo-transverse anastomosis for the ascending colon cancer. Post-operative evolution was favorable. Histological result showed mucinous adenocarcinoma of the ascending colon and tubulovillous adenoma, with moderate dysplasia, in the rectosigmoid. At 6-month, endoscopic evaluation showed normal aspect of anastomosis without presence of other colonic lesions.

Cite this article:
Vancouver
Berevoescu N, Bordea A, Scăunașu R, Berevoescu M, Cristian D. A case of silent colonic lesions associated with streptococcus gallolyticus, bacteremia and endocarditis. J Clin Investig Surg. 2018 Nov 25;3(2):105-109. Available from: https://www.proscholar.org/jcis/archive/vol.3/iss.2/10/ doi: 10.25083/2559.5555/3.2/105.109
NLM
Berevoescu N, Bordea A, Scăunașu R, Berevoescu M, Cristian D. A case of silent colonic lesions associated with streptococcus gallolyticus, bacteremia and endocarditis. J Clin Investig Surg. 2018 Nov;3(2):105-109. doi: 10.25083/2559.5555/3.2/105.109.
AMA
Berevoescu N, Bordea A, Scăunașu R, Berevoescu M, Cristian D. A case of silent colonic lesions associated with streptococcus gallolyticus, bacteremia and endocarditis. J Clin Investig Surg. 2018;3(2):105-109.
MLA
Berevoescu, Nicolae, et al. “A case of silent colonic lesions associated with streptococcus gallolyticus, bacteremia and endocarditis.” Journal of Clinical and Investigative Surgery 3.2 (2018): 105-109. doi:10.25083/2559.5555/3.2/105.109.
APA
Berevoescu, N., Bordea, A., Scăunașu, R., Berevoescu, M., & Cristian, D. (2018). A case of silent colonic lesions associated with streptococcus gallolyticus, bacteremia and endocarditis. Journal of Clinical and Investigative Surgery, 3(2), 105-109.
ISO 690
Berevoescu
, Nicolae, et al. A case of silent colonic lesions associated with streptococcus gallolyticus, bacteremia and endocarditis. Journal of Clinical and Investigative Surgery, 2018, 3.2: 105-109.