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Henry W. Murray, MD; Richard B. Roberts, MD

Arch Intern Med. 1978;138(7):1097-1099.

Abstract
Twenty-six adults with Streptococcus bovis endocarditis and ten with bacteremia alone were studied to determine possible portals of entry. Of 36 patients (17 with endocarditis, eight with bacteremia alone), 25 had gastrointestinal lesions or manipulation. In 22, the gastrointestinal tract appeared to be the source of S bovis bacteremia. Four patients had either carcinoma of the colon (two) or potentially malignant villous adenomas (two) when first seen because of S bovis bacteremia. None of these, nor two other patients with benign colonic. polyps, had bowel-related symptoms or signs prior to admission.

Since S bovis is a normal intestinal tract inhabitant, bacteremia may frequently be associated with bowel lesions. Streptococcus bovis bacteremia may provide an early clue to the presence of serious and clinically unexpected gastrointestinal disease. Gastrointestinal tract evaluation should be part of S bovis bacteremia patient management, with or without endocarditis.

(Arch Intern Med 138:1097-1099, 1978)

Author Affiliations
From the Department of Medicine and the Division of Infectious Diseases, The New York Hospital-Cornell Medical Center, New York.

Footnotes
Accepted for publication Oct 18, 1977.

Reprint requests to Infectious Diseases Division, The New York Hospital, 525 E 68th St, New York, NY 10021 (Dr Roberts).

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