Department of Cardiovascular Surgery, St. Mary's Hospital.
Kurume Med J. 2023 Nov 30;69(1.2):111-114. doi: 10.2739/kurumemedj.MS6912003. Epub 2023 Aug 7.
We report a case of Streptococcus mitis endocarditis associated with early gastric carcinoma. A 71-year-old man who had been diagnosed with aortic regurgitation (AR) two years previously was referred for valve surgery and evaluation of elevated inflammatory markers. Four months previously, atrophic gastritis, early gastric adenocarcinoma, and colon polyp had been identified in the patient during endoscopy. However, Helicobacter pylori testing was negative. On admission, he had no dental diseases or recent oral procedures. Echocardiography demonstrated severe AR and mobile vegetation on the aortic valve. Magnetic resonance imaging revealed cerebral embolism and spondylodiscitis. Blood cultures grew Streptococcus mitis. At surgery, destruction of the left cusp with vegetation and a perforation of the non-coronary cusp were found; in addition, aortic valve replacement was performed. Although the association between Streptococcus bovis bacteremia and colon neoplasm is well recognized, the association between Streptococcus mitis endocarditis and gastrointestinal carcinoma should also be kept in mind.
我们报告一例与早期胃癌相关的米氏链球菌心内膜炎。一名 71 岁男性，两年前被诊断为主动脉瓣反流（AR），因瓣膜手术和炎症标志物升高而被转介。四个月前，患者在胃镜检查中发现萎缩性胃炎、早期胃腺癌和结肠息肉。然而，幽门螺杆菌检测呈阴性。入院时，他没有牙科疾病或近期口腔手术。超声心动图显示严重的 AR 和主动脉瓣上的移动性赘生物。磁共振成像显示脑栓塞和脊椎炎。血培养出米氏链球菌。手术中发现左瓣破坏伴赘生物和无冠状动脉瓣穿孔；此外，还进行了主动脉瓣置换术。虽然众所周知，B 型链球菌菌血症与结肠肿瘤之间存在关联，但也应注意到米氏链球菌心内膜炎与胃肠道癌之间的关联。
