Korean J Lab Med.  2010 Apr;30(2):160-165. 10.3343/kjlm.2010.30.2.160.

A Case of Streptococcus gallolyticus subsp. gallolyticus Infective Endocarditis with Colon Cancer: Identification by 16S Ribosomal DNA Sequencing

Affiliations
  • 1Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea. euichong@snu.ac.kr

Abstract

Although the association between Streptococcus bovis endocarditis and colon carcinoma is well known, very few cases of S. bovis infection associated with underlying malignancies have been reported in Korea. The S. bovis group has been recently reclassified and renamed as Streptococcus gallolyticus and Streptococcus infantarius subspecies under a new nomenclature system. We report a case of infective endocarditis with colon cancer caused by S. gallolyticus subsp. gallolyticus (previously named S. bovis biotype I). A 59-yr-old woman presented with a 1-month history of fever. Initial blood cultures were positive for gram-positive cocci, and echocardiography showed vegetation on mitral and aortic valves. Antibiotic treatment for infective endocarditis was started. The infecting strain was a catalase-negative and bile-esculin-positive alpha-hemolytic Streptococcus susceptible to penicillin and vancomycin. The strain was identified as S. gallolyticus subsp. gallolyticus with the use of the Vitek 2 GPI and API 20 Strep systems (bioMerieux, USA). The 16S rDNA sequences of the blood culture isolates showed 100% homology with those of S. gallolyticus subsp. gallolyticus reported in GenBank. The identification of the infecting organism, and the subsequent communication among clinical microbiologists and physicians about the changed nomenclature, led to the detection of colon cancer. The patient recovered after treatment with antibiotics, valve surgery, and operation for colon cancer. This is the first report of biochemical and genetic identification of S. gallolyticus subsp. gallolyticus causing infective endocarditis associated with underlying colon cancer in a Korean patient.

Keyword

Streptococcus gallolyticus; Endocarditis; Colon cancer; rDNA sequencing

MeSH Terms

Anti-Bacterial Agents/therapeutic use
Colonic Neoplasms/*complications/diagnosis
Echocardiography
Endocarditis, Bacterial/complications/diagnosis/*microbiology
Female
Humans
Middle Aged
RNA, Ribosomal, 16S/genetics
Sequence Analysis, DNA
Streptococcal Infections/complications/diagnosis/*microbiology
Streptococcus bovis/genetics/*isolation &purification

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Reference

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.
2.Ruoff KL., Miller SI., Garner CV., Ferraro MJ., Calderwood SB. Bacteremia with Streptococcus bovis and Streptococcus salivarius: clinical correlates of more accurate identification of isolates. J Clin Microbiol. 1989. 27:305–8.
3.Herrero IA., Rouse MS., Piper KE., Alyaseen SA., Steckelberg JM., Patel R. Reevaluation of Streptococcus bovis endocarditis cases from 1975 to 1985 by 16S ribosomal DNA sequence analysis. J Clin Microbiol. 2002. 40:3848–50.
4.Schlegel L., Grimont F., Ageron E., Grimont PA., Bouvet A. Reappraisal of the taxonomy of the Streptococcus bovis/Streptococcus equinus complex and related species: description of Streptococcus gallolyticus subsp. gallolyticus subsp. nov., S. gallolyticus subsp. macedonicus subsp. nov. and S. gallolyticus subsp. pasteurianus subsp. nov. Int J Syst Evol Microbiol. 2003. 53:631–45.
5.Beck M., Frodl R., Funke G. Comprehensive study of strains previously designated Streptococcus bovis consecutively isolated from human blood cultures and emended description of Streptococcus gallolyticus and Streptococcus infantarius subsp. coli. J Clin Microbiol. 2008. 46:2966–72.
6.Mc CW., Mason JM 3rd. Enterococcal endocarditis associated with carcinoma of the sigmoid; report of a case. J Med Assoc State Ala. 1951. 21:162–6.
7.Klein RS., Catalano MT., Edberg SC., Casey JI., Steigbigel NH. Streptococcus bovis septicemia and carcinoma of the colon. Ann Intern Med. 1979. 91:560–2.
8.Wilson WR., Thompson RL., Wilkowske CJ., Washington JA 2nd., Giuliani ER., Geraci JE. Short-term therapy for streptococcal infective endocarditis. Combined intramuscular administration of penicillin and streptomycin. JAMA. 1981. 245:360–3.
Article
9.Ellmerich S., Scholler M., Duranton B., Gosse F., Galluser M., Klein JP, et al. Promotion of intestinal carcinogenesis by Streptococcus bovis. Carcinogenesis. 2000. 21:753–6.
10.Coykendall AL. Classification and identification of the viridans streptococci. Clin Microbiol Rev. 1989. 2:315–28.
Article
11.Poyart C., Quesne G., Trieu-Cuot P. Taxonomic dissection of the Streptococcus bovis group by analysis of manganese-dependent superoxide dismutase gene (sodA) sequences: reclassification of Streptococcus infantarius subsp. coli as Streptococcus lutetiensis sp. nov. and of Streptococcus bovis biotype 11.2 as Streptococcus pasteurianus sp. nov. Int J Syst Evol Microbiol. 2002. 52:1247–55.
12.Schlegel L., Grimont F., Collins MD., Regnault B., Grimont PA., Bouvet A. Streptococcus infantarius sp. nov., Streptococcus infantarius subsp. infantarius subsp. nov. and Streptococcus infantarius subsp. coli subsp. nov., isolated from humans and food. Int J Syst Evol Microbiol. 2000. ;50 Pt. 4:1425–34.
13.Clarridge JE 3rd., Attorri SM., Zhang Q., Bartell J. 16S ribosomal DNA sequence analysis distinguishes biotypes of Streptococcus bovis: Streptococcus bovis Biotype II/2 is a separate genospecies and the predominant clinical isolate in adult males. J Clin Microbiol. 2001. 39:1549–52.
14.Devriese LA., Vandamme P., Pot B., Vanrobaeys M., Kersters K., Haesebrouck F. Differentiation between Streptococcus gallolyticus strains of human clinical and veterinary origins and Streptococcus bovis strains from the intestinal tracts of ruminants. J Clin Microbiol. 1998. 36:3520–3.
15.Farrow JA., Kruze J., Phillips BA., Bramley AJ., Collins ME. Taxonomic studies on Streptococcus bovis and Streptococcus equinus: description of Streptococcus alactolyticus sp. nov. and Streptococcus saccharolyticus sp. nov. Syst Appl Microbiol. 1984. 5:467–82.
16.Kwack KK., So SC., Park HK., Lee DK., Kim JH., Lyu DY, et al. A case of subacute infective endocarditis with colon cancer caused by Streptococcus bovis. Korean J Med. 2000. 59:198–202.
17.Koh DW., Choi JH., Kim YS., Koo JS., Cho YJ., Park DK, et al. A case of two synchronous colon cancers accompanied by Streptococcus bovis endocarditis. Korean J Gastrointest Endosc. 2001. 23:503–6.
18.Uh Y., Kwon O., Yoon KJ., Hwang GY., Kim HY. Underlying diseases associated with Streptococcus bovis bacteremia and antimicrobial susceptibility of the organism. Korean J Clin Microbiol. 2006. 9:36–41.
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