Streptococcus Gallolyticus Bacteraemia associated with colonic adenomatous polyps

 

A. Murinello¹, P. Mendonça¹, C. Ho¹, P. Tavares¹, H. Peres¹, R. Rio Tinto², A. Morbey¹, C. Campos¹, A. Lázaro¹, A. Milheiro, M. J. Arias, J. Oliveira¹, S. Braz¹

 

Resumo

A bacteriémia por Streptococcus gallolyticus associa-se frequentemente ao carcinoma colorrectal, tornando obrigatória a colonoscopia nestas situações. A endocardite bacteriana e a artrite séptica são também comuns neste tipo de bacteriémias. Tem sido levantada a hipótese das bactérias intestinais poderem ter um papel promotor de hiperproliferação celular aberrante em lesões cólicas pré-neoplásicas, aparentemente devido a processos inflamatórios crónicos e produção de metabolitos carcinogénicos. Os autores apresentam o caso dum doente com vários pólipos adenomatosos tubulares do cólon direito, em dois dos quais se demonstrou uma área de displasia de alto grau adjacente a zona de colite infecciosa bacteriana, associados a quadro clínico de infecção sistémica por Streptococcus gallolyticus e artrite do tornozelo.

 

Summary

Bacteraemia due to Streptococcus gallolyticus is frequently associated with colorectal carcinoma, making evaluation of the gastrointestinal tract by colonoscopy obligatory in such cases. Bacterial endocarditis and purulent arthritis are also common in patients with these bacteraemias. Intestinal bacteria could behave as promoters of aberrant hyperproliferative behaviour in preneoplastic colorectal lesions, apparently due to chronic inflammatory processes and production of carcinogenic metabolites. The authors treated a patient with several tubular adenomatous polyps of the right colon, two of which showed areas of high-grade dysplasia adjacent to areas of infectious bacterial colitis associated with Streptococcus gallolyticus bacteraemia and unilateral ankle arthritis.

 

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(1) Departments of Internal Medicine 1, Pathology, Histopathology, Surgery and Gastroenterology, Curry Cabral Hospital, Lisbon, Portugal.

(2) Department of Gastroenterology, Stº Antº Capuchos Hospital, Lisbon. Portugal.

 

 

Recebido para publicação: 26/09/2005

Aceite para publicação: 15/02/2006