may mr

Morning ReportCharita Vadlamudi

5/8/2014

Group D Strep Bacteremia

• Catalase-negative, gram positive cocci, express Lancefield Group D antigen

Association with disease

• S. bovis biotype 1 (S. gallolyticus gallolyticus)• Endocarditis and colonic neoplasm

• S. bovis biotype 2.1 • Biliary tract disease

• S. bovis biotype 2.2• Infections in neonates and infants

S. gallolyticus gallolyticus

• GI tract is most likely source for entry

• Accounts for ~6% of IE cases (10% in Europe to 2% in N. America)

• Typically older, less likely than other Pts with IE to have risk factors for IE such as IV drug use or structural heart disease.

• Tend to have sub-acute presentation, large vegetations, and more likely to involve >1 valve

• Some studies have shown IE in 43-100% of pts infected with S. gallolyticus (only 8-29% seen in S. bovis biotype II)

• Controversial relationship between GDS fecal carriage and colorectal cancer.• GDS has been isolated in the stool of 2-12% healthy people and up to 50 % of individuals with colorectal

tumors

• Current theory is that the organism likely exerts its effect during the later stages of colorectal cancer rather than as an inducer of mutations in the early phases of tumorigenesis

Recommendations

• ECHO

• Colonoscopy

References

• http://adoptamicrobe.blogspot.com/2006/11/streptococcus-bovis.html

• UpToDate