Colon cancer presenting as Streptococcus gallolyticus infective endocarditis

Kok HYL, Jureen R, Soon CY, Tey BH
Correspondence: Dr Henry Kok, drhenrykok@yahoo.com

ABSTRACT
A 58-year-old Chinese man presented with a three-week history of fever. He had a background history of rheumatic heart disease, hypertension, and thalassaemia. He was found to have infective endocarditis of the aortic valve due to Streptococcus gallolyticus. During the hospital stay, he developed a few episodes of haematochaezia and was subsequently found to have colonic carcinomain- situ. He completed appropriate antibiotic treatment for his infective endocarditis and underwent a left hemicolectomy with primary anastomosis. The association between Streptococcus gallolyticus infective endocarditis and colonic neoplasm is well documented. This case report stresses the importance of performing routine colonoscopy to look for colonic neoplastic change in patients diagnosed to have Streptococcus gallolyticus infective endocarditis. The early diagnosis of the colonic neoplasm has enabled our patient to have a curative surgery without compromising his quality of life.

Keywords: bacterial endocarditism, colonoscopy, colorectal neoplasm, gastrointestinal haemorrhage, infective endocarditis, Streptococcus bovis, Streptococcus gallolyticus infective endocarditis
Singapore Med J 2007; 48(2): e43–e45