Chime Chukwunonso, Patel Harish, Kumar Kishore, Elwan Ahmed, Bhandari Manoj, Ihimoyan Ariyo
BronxCare Health System, A Clinical Affiliate of Mt Sinai Health Systems and an Academic Affiliate of Icahn School of Medicine, USA.
Case Rep Gastrointest Med. 2019 Jul 3;2019:4205603. doi: 10.1155/2019/4205603. eCollection 2019.
Bacterial endocarditis is commonly encountered in clinical practice. Many bacterial species have been implicated; however, species (formerly "") has driven attention given a historical association with colon cancer. Colonoscopy is recommended in an individual with endocarditis or bacteremia to evaluate the possibility of high-grade adenoma or colon cancer. There has been no firm recommendation for prophylactic antibiotics to prevent bacterial endocarditis for patients undergoing endoscopic procedures and postcolonoscopy bacteremia in an individual with an endoscopic procedure indicated for bacteremia has not been reported. Studies have been aimed at understanding the association between colon cancer and this bacterial pathogen. There are suggestions that the systemic manifestation of , a commensal in the colon premalignant cells, may be further predisposed by patient's immunocompromised status. We present a case of the 72-year-old man with the newly diagnosed multiple myeloma presented with aortic valve endocarditis and bacteremia. Colonoscopy revealed colon cancer and high-grade adenoma; few hours after procedure, he presented with bacteremia. In conclusion, our case realigns association of to colon cancer, especially in an individual with altered immunity, and is novel to demonstrate the rare association of two distinct bacteria of species associated with cancer. Preendoscopic antibiotics use, though not standard of care, can be considered in the high-risk individual. Altered immunity can be considered the "missing link" inciting bacteremia in individuals with -associated colon cancer.
细菌性心内膜炎在临床实践中较为常见。许多细菌种类都与之相关；然而，[具体菌种名称（原“”）]由于与结肠癌的历史关联而备受关注。对于患有[具体菌种名称]心内膜炎或菌血症的个体，建议进行结肠镜检查以评估高级别腺瘤或结肠癌的可能性。对于接受内镜检查的患者，尚无关于预防性使用抗生素预防细菌性心内膜炎的确切建议，并且尚未报道过因内镜检查而导致菌血症的个体在结肠镜检查后发生菌血症的情况。已有研究旨在了解结肠癌与这种细菌病原体之间的关联。有迹象表明，作为结肠癌前细胞中共生菌的[具体菌种名称]的全身表现可能会因患者的免疫功能低下状态而进一步加重。我们报告一例72岁新诊断为多发性骨髓瘤的男性患者，其出现主动脉瓣心内膜炎和[具体菌种名称]菌血症。结肠镜检查发现结肠癌和高级别腺瘤；检查后数小时，他出现了[具体菌种名称]菌血症。总之，我们的病例重新梳理了[具体菌种名称]与结肠癌的关联，特别是在免疫功能改变的个体中，并且首次证明了与癌症相关的两种不同[具体菌种名称]细菌的罕见关联。对于高危个体，可以考虑使用内镜检查前抗生素，尽管这并非标准治疗方法。免疫功能改变可被视为引发与[具体菌种名称]相关结肠癌个体菌血症的“缺失环节”。
