Mulita Avenir, Ajayi Tokunbo
Department of Internal Medicine, North Shore Medical Center, Salem, Massachusetts, USA.
BMJ Case Rep. 2014 May 29;2014:bcr2014203695. doi: 10.1136/bcr-2014-203695.
Even though Streptococcus bacteraemia is an infrequent presentation of colonic malignancies, there is a well-established link between Streptococcus bovis bacteraemia and colonic malignancies. Most of the physicians are well aware of this correlation and further workup is pursued in most of the cases. However, many physicians may not be aware that other species of Streptococcus viridians, other than S. bovis, can be associated with colonic malignancies. In this case report, we present a case of Streptococcus viridians (anginosus) bacteraemia as a complication of an undiagnosed sigmoid adenocarcinoma. While further evidence is needed to warrant a gastrointestinal (GI) workup in a patient with other species of Streptococcus viridians bacteraemia, we would like to increase the awareness in the physicians' community regarding Streptococcus viridians, other than S. bovis bacteraemia. This would be especially relevant for patients who have no GI screening, as Streptococcus viridians bacteraemia can be an early sign of colonic neoplasm.
尽管链球菌血症是结肠恶性肿瘤的一种罕见表现,但牛链球菌血症与结肠恶性肿瘤之间存在着已被充分证实的联系。大多数医生都清楚这种关联,并且在大多数病例中都会进行进一步检查。然而,许多医生可能并未意识到,除牛链球菌外,其他种类的草绿色链球菌也可能与结肠恶性肿瘤有关。在本病例报告中,我们呈现了一例由未被诊断出的乙状结肠腺癌引发的草绿色链球菌(咽峡炎链球菌)血症病例。虽然对于患有其他种类草绿色链球菌血症的患者,需要进一步证据来证明进行胃肠(GI)检查的必要性,但我们希望提高医生群体对除牛链球菌血症之外的草绿色链球菌的认识。这对于未进行胃肠筛查的患者尤为重要,因为草绿色链球菌血症可能是结肠肿瘤的早期迹象。