Leborgne J, Guiberteau-Canfrere V, Lehur P A, Bitar O, Remadi J P, Raffi R, Michaud J L
Clinique chirurgicale II, Hôpital G. et R. Laënnec, Nantes.
Chirurgie. 1992;118(3):177-82.
The problems arising from the discovery of a colorectal tumor during an infectious endocarditis caused by Streptococci D have rarely been mentioned in the surgical literature. The frequency of association of an asymptomatic colorectal tumor and of a Streptococcus bovi endocarditis is now undisputed. This notion implies the systematic search for an intestinal lesion (adenoma or carcinoma) in case of endocarditis or septicemia without involvement of the valves, caused by a streptococcus of group D. The authors report about 3 cases of enterococcal (1 case) and S. bovis (2 cases) infectious endocarditis revealing a colic adenocarcinoma (2 cases) and a villous adenoma (1 case), all being perfectly latent. The specific therapeutic problems arising from this association are outlined, including the antibiotic therapy, the role of the anticoagulant treatment and the priority given to valve surgery in case of hemodynamic instability.
由D组链球菌引起的感染性心内膜炎期间发现结直肠肿瘤所引发的问题，在外科文献中鲜有提及。无症状结直肠肿瘤与牛链球菌心内膜炎的关联频率如今已无可争议。这一观点意味着，对于由D组链球菌引起的、未累及瓣膜的心内膜炎或败血症病例，需系统性地排查肠道病变（腺瘤或癌）。作者报告了3例肠球菌（1例）和牛链球菌（2例）感染性心内膜炎病例，这些病例分别发现了结肠腺癌（2例）和绒毛状腺瘤（1例），所有这些病变此前均完全隐匿。文中概述了这种关联所引发的特定治疗问题，包括抗生素治疗、抗凝治疗的作用以及血流动力学不稳定时瓣膜手术的优先性。
