Association of Streptococcus bovis bacteremia with colonic neoplasia and extracolonic malignancy

Background: The association between Streptococcus bovis bacteremia and colonic neoplasia is well described; however, the relationship between S bovis and neoplasia outside the colon has not been well evaluated. Hypothesis: S bovis bacteremia may be associated with colonic neoplasia and extracolonic malignancy. Design: Retrospective review of all documented cases of S bovis bacteremia identified by a search of computerized bacteriology records. Setting: One tertiary referral hospital and 1 community hospital located in the same city. Patients: Forty-five patients (41 adults, 4 children) with documented S bovis bacteremia during a 12-year period were identified. Main Outcome Measures: Available patient records were reviewed to identify the presence of colonic neoplasia, the use of gastrointestinal endoscopy, and the presence of gastrointestinal or extraintestinal malignancies. Results: Seventeen patients (41% of adult patients) underwent colonoscopy. Colonic neoplasia was present in 16 patients (39% of adults), with 3 of these patients having invasive colorectal cancer (7% of adults). Invasive cancer was present in 13 patients (32% of adults). Eight patients had malignant lesions arising within the gastrointestinal tract, and 5 patients had extraintestinal malignancies. Conclusion: S bovis bacteremia is associated with both colonic neoplasia and extracolonic malignancy.