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Year : 2011  |  Volume : 48  |  Issue : 3  |  Page : 375-376

Streptococcus bovis bacteremia and colorectal carcinoma

Department of Microbiology, Centre for Basic Sciences, Kasturba Medical College, Manipal University, Manipal, Karnataka, India

Date of Web Publication14-Sep-2011

Correspondence Address:
S P Maurya
Department of Microbiology, Centre for Basic Sciences, Kasturba Medical College, Manipal University, Manipal, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-509X.84924

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How to cite this article:
Maurya S P. Streptococcus bovis bacteremia and colorectal carcinoma. Indian J Cancer 2011;48:375-6

How to cite this URL:
Maurya S P. Streptococcus bovis bacteremia and colorectal carcinoma. Indian J Cancer [serial online] 2011 [cited 2021 Aug 3];48:375-6. Available from: https://www.indianjcancer.com/text.asp?2011/48/3/375/84924


There has been a close linkage between Streptococcus bovis bacteremia and tumors of human colon. [1],[2] However, this fecal bacterium is infrequently reported in microbiology laboratories. One of the reasons could be that the minimal test scheme followed for routine identification in most laboratories mis-identifies it as enterococci; and the pressure to send a report as soon as possible, along with high cost of automated identification systems, reduces the spectrum of more definitive identification. [3]

We present here an entity that later proved to be Streptococcus bovis; and to the best of our knowledge, from India, this could be the first documented case of S. bovis bacteremia associated with colorectal carcinoma. Further, S. bovis bacteremia with such mis-identification has never been reported. This does not mean that cases of such mis-identification have not occurred previously. The finding is particularly important in a country where limitation of resources together with market competition leads laboratories to look for more common pathogens.

A 59-year-old man with known history of rectal carcinoma completed adjuvant chemotherapy and radiotherapy a month back. He presented with severe intractable hiccoughs due to which he was unable to sleep the entire night. There was no history of fever, vomiting or abdominal pain. He was passing urine and stools normally. CT abdomen showed diffuse wall thickening with target appearance of the distal ileal loops with mild proximal dilatation of small-bowel loops. Features were suggestive of inflammatory wall thickening - likely to be radiation enteritis. The general physical and systemic examinations were unremarkable, not indicative of involvement of other organ systems. He was admitted and started on Piperacillin-Tazobactam, Amikacin, IV fluids, Potchlor, Rantac, Baclofen and Perinorm. His general condition improved slowly after 3 days. On discharge, the patient's condition was stable and hiccoughs decreased. The patient did not visit for follow-up.

Meanwhile, blood BacT was sent for culture, which beeped positive for bacterial growth a day later. The organism was Gram-positive cocci, predominantly in pairs and short chains; catalase negative and bile esculine positive. The report was sent as enterococcus species grown in culture sensitive to ampicillin, gentamicin, doxycycline and erythromycin; and resistant to cotrimoxazole. The entire process took 3 days; and by this time, the patient had been discharged. We further evaluated our identification for the possibility of S. bovis. The result "negative growth in 6.5% NaCl nutrient broth" came 5 days later, and also the isolate hydrolyzed starch. We confirmed the isolate as Streptococcus bovis.

Though not yet proven to be a causal relation, S. bovis has an active role in promoting intestinal carcinogenesis. [4] In the past, need for awareness of differences between enterococci and group D streptococci and for correct identification of isolates from patients with bacteremia and endocarditis has been emphasized. [3] However, the knowledge and importance of S. bovis in colon cancer have not been sufficiently translated into routine practice. [5]

 » Acknowledgement Top

I would like to thanks Dr. Vandana K.E., Department of Microbiology, Kasturba Medical College, Manipal, for her kind support in the performance of this study.

 » References Top

1.Klein RS, Recco RA, Catalano MT, Edberg SC, Casey JI, Steigbigel NH. Association of Streptococcus bovis with carcinoma of the colon. N Engl J Med 1977;297:800-2.  Back to cited text no. 1
2.Levinson W. Review of medical microbiology and immunology. 10th ed. New York: McGraw-Hill Medical Publishing; 2008. p. 114.  Back to cited text no. 2
3.Gross KC, Houghton MP, Senterfit LB. Presumptive speciation of Streptococcus bovis and other group D streptococci from human sources by using arginine and pyruvate tests. J Clin Microbiol 1975;1:54-60.  Back to cited text no. 3
4.Biarc J, Nguyen IS, Pini A, Gossé F, Richert S, Thiersé D, et al. Carcinogenic properties of proteins with pro-inflammatory activity from Streptococcus infantarius. Carcinogenesis 2004;25:1477-84.  Back to cited text no. 4
5.Ferrari A, Botrugno I, Bombelli E, Dominioni T, Cavazzi E, Dionigi P. Colonoscopy is mandatory after Streptococcus bovis endocarditis: A lesson still not learned. Case report. World J Surg Oncol 2008;6:49.  Back to cited text no. 5

This article has been cited by
1 result 1 Document Is colonoscopy necessary in cases of infection by Streptococcus bovis biotype II?
Corredoira, J.C., Alonso, M.P., García-País, M.J., (...), Tjalsma, H., Varela, J.
Source of the Document European Journal of Clinical Microbiology and Infectious Diseases. 2014;
2 Is colonoscopy necessary in cases of infection by Streptococcus bovis biotype II?
J. C. Corredoira,M. P. Alonso,M. J. García-País,R. Rabuñal,F. García-Garrote,L. López-Roses,A. Lancho,A. Coira,J. Pita,D. Velasco,M. J. López-Álvarez,H. Tjalsma,J. Varela
European Journal of Clinical Microbiology & Infectious Diseases. 2013;
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