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Published in: Gut Pathogens 1/2024

Open Access 01-12-2024 | Streptococci | Case Report

Bacteremia from streptococcus constellatus revealing a gastrointestinal stromal tumor

Authors: Salvatore Chessa, Elena Belfiori, Giulia Mandis, Enrico Urru, Giovanna Manconi, Angelo Scuteri

Published in: Gut Pathogens | Issue 1/2024

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Abstract

Background

Pyogenic Liver Abscesses (PLA) are the most common type of visceral abscess. They generally develop in a context of biliary disease or hematogenous seeding, but a complete diagnostic work-up is always required in order not to miss other important causes, including above all malignancies of the gastro-intestinal tract.

Case presentation

Herein, we report a particular case of a 80 years-old immunocompetent woman hospitalized for sepsis. At the end of the diagnostic process, Streptococcus constellatus (Sc) was identified as the cause of sepsis, multiple PLA were found together with a previous unknown ileal malignancy. We speculated about a possible correlation among these three entities (i.e. sepsis from Sc, PLA and tumors).

Conclusions

Detection of Sc in blood should raise red flags in clinicians as aggressive clinical presentation are possible.
Literature
1.
go back to reference Whiley RA, Beighton D, Winstanley TG, Fraser HY, Hardie JM, Streptococcus intermedius. S treptococcus constellatus and Streptococcus anginosus (the Streptococcus mileri group): association with different body sites and clinical infections. J Clin Microbiol 1992; 30: 243-4. Whiley RA, Beighton D, Winstanley TG, Fraser HY, Hardie JM, Streptococcus intermedius. S treptococcus constellatus and Streptococcus anginosus (the Streptococcus mileri group): association with different body sites and clinical infections. J Clin Microbiol 1992; 30: 243-4.
3.
go back to reference Mejaro B, Edwardsson S. Streptococcus milleri (Guthof); an indigenous organism of the human oral cavity. Arch Oral Biol. 1975;20:757.CrossRef Mejaro B, Edwardsson S. Streptococcus milleri (Guthof); an indigenous organism of the human oral cavity. Arch Oral Biol. 1975;20:757.CrossRef
4.
go back to reference Nagamune H, Whiley RA, Goto T, Inai Y, Maeda T, Hardie JM, Kourai H. Distribution of the intermedilysin gene among the anginosus group Streptococci and correlation between intermedilysin production and deep-seated Infection with Streptococcus intermedius. J Clin Microbiol. 2000;38:220.CrossRefPubMedPubMedCentral Nagamune H, Whiley RA, Goto T, Inai Y, Maeda T, Hardie JM, Kourai H. Distribution of the intermedilysin gene among the anginosus group Streptococci and correlation between intermedilysin production and deep-seated Infection with Streptococcus intermedius. J Clin Microbiol. 2000;38:220.CrossRefPubMedPubMedCentral
5.
go back to reference Clarridge JE, Attorri S, Musher DM, Hebert J, Dunbar S. Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (Streptococcus Milleri Group) are of different clinical importance and are not equally associated with abscess. Clin Infect Dis. 2001;32(10):1511–5.CrossRef Clarridge JE, Attorri S, Musher DM, Hebert J, Dunbar S. Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (Streptococcus Milleri Group) are of different clinical importance and are not equally associated with abscess. Clin Infect Dis. 2001;32(10):1511–5.CrossRef
8.
go back to reference Akuzawa N, Hatori T, Kitahara Y, Kurabayashi M. Multiple liver abscesses and bacteremia caused by Streptococcus constellatus infection: a case report. Clin Case Rep. 2017;5(1):69–74.CrossRefPubMed Akuzawa N, Hatori T, Kitahara Y, Kurabayashi M. Multiple liver abscesses and bacteremia caused by Streptococcus constellatus infection: a case report. Clin Case Rep. 2017;5(1):69–74.CrossRefPubMed
9.
go back to reference Rossi G, Nguyen Y, Lafont E, et al. Large retrospective study analysing predictive factors of primary treatment failure, recurrence and death in pyogenic liver abscesses. Infection. 2022;50:1205–15.CrossRefPubMed Rossi G, Nguyen Y, Lafont E, et al. Large retrospective study analysing predictive factors of primary treatment failure, recurrence and death in pyogenic liver abscesses. Infection. 2022;50:1205–15.CrossRefPubMed
10.
go back to reference Zhang L, Liu P, Li Y, et al. Rapid development of an intracranial infectious aneurysm secondary to Streptococcus constellatus infection. Intensive Care Med. 2023;49:593–4.CrossRefPubMed Zhang L, Liu P, Li Y, et al. Rapid development of an intracranial infectious aneurysm secondary to Streptococcus constellatus infection. Intensive Care Med. 2023;49:593–4.CrossRefPubMed
11.
go back to reference Matsutani T, Onda M, Miyashita M, Hao K, Yokoyama S, et al. Liver abscesses associated with stromal tumour of the stomach in a young woman. Eur J Gastroenterol Hepatol. 2001;13:1485–148.CrossRefPubMed Matsutani T, Onda M, Miyashita M, Hao K, Yokoyama S, et al. Liver abscesses associated with stromal tumour of the stomach in a young woman. Eur J Gastroenterol Hepatol. 2001;13:1485–148.CrossRefPubMed
12.
go back to reference Kim BH, Lee JH, Baik du S, Yun SW, Kim JH, et al. A case of malignant gastrointestinal stromal tumor of ileum with liver abscess. Korean J Gastroenterol. 2007;50:393–7.PubMed Kim BH, Lee JH, Baik du S, Yun SW, Kim JH, et al. A case of malignant gastrointestinal stromal tumor of ileum with liver abscess. Korean J Gastroenterol. 2007;50:393–7.PubMed
13.
go back to reference Kumar A, Artifon E, Siegel C, Halwan B. Gastrointestinal stromal tumor in association with pyogenic liver abscess. Gastroenterol Hepatol. 2008;4:818–9. Kumar A, Artifon E, Siegel C, Halwan B. Gastrointestinal stromal tumor in association with pyogenic liver abscess. Gastroenterol Hepatol. 2008;4:818–9.
14.
go back to reference Kwon Y, Dang ND, Elmunzer BJ. Gastrointestinal stromal tumor complicated by Streptococcus milleri bacteremia and liver abscess. Eur J Gastroenterol Hepatol. 2009;21(7):824–6.CrossRefPubMed Kwon Y, Dang ND, Elmunzer BJ. Gastrointestinal stromal tumor complicated by Streptococcus milleri bacteremia and liver abscess. Eur J Gastroenterol Hepatol. 2009;21(7):824–6.CrossRefPubMed
16.
go back to reference Sasaki H, Ishizuka T, Muto M, Nezu M, Nakanishi Y, et al. Presence of Streptococcus anginosus DNA in esophageal cancer, dysplasia of esophagus, and gastric cancer. Cancer Res. 1998;58(14):2991–5.PubMed Sasaki H, Ishizuka T, Muto M, Nezu M, Nakanishi Y, et al. Presence of Streptococcus anginosus DNA in esophageal cancer, dysplasia of esophagus, and gastric cancer. Cancer Res. 1998;58(14):2991–5.PubMed
17.
go back to reference Zhou CB, Pan SY, Jin P, Deng JW, Xue JH, Ma XY, et al. Fecal signatures of Streptococcus anginosus and Streptococcus constellatus for noninvasive screening and early warning of gastric cancer. Gastroenterology. 2022;162(7):1933–47.CrossRefPubMed Zhou CB, Pan SY, Jin P, Deng JW, Xue JH, Ma XY, et al. Fecal signatures of Streptococcus anginosus and Streptococcus constellatus for noninvasive screening and early warning of gastric cancer. Gastroenterology. 2022;162(7):1933–47.CrossRefPubMed
18.
go back to reference Sasaki H, Hiroyasu I, Ishizuka T, Kogoma Y, Sugimura T, Terada M. Presence of Streptococcus DNA sequence in surgical specimens of gastric cancer. Jpn J Cancer Res. 1995;86:791–4.CrossRefPubMedPubMedCentral Sasaki H, Hiroyasu I, Ishizuka T, Kogoma Y, Sugimura T, Terada M. Presence of Streptococcus DNA sequence in surgical specimens of gastric cancer. Jpn J Cancer Res. 1995;86:791–4.CrossRefPubMedPubMedCentral
19.
go back to reference Rawla P, Vellipuram AR, Bandaru SS, Raj JP. Colon carcinoma presenting as Streptococcus anginosus bacteremia and liver abscess. Gastroenterol Res. 2017;10(6):376–9.CrossRef Rawla P, Vellipuram AR, Bandaru SS, Raj JP. Colon carcinoma presenting as Streptococcus anginosus bacteremia and liver abscess. Gastroenterol Res. 2017;10(6):376–9.CrossRef
20.
go back to reference Millichap JJ, McKendrick AI, Drelichman VS. Streptococcus intermedius liver abscesses and colon cancer: a case report. West Indian Med J. 2005;54(5):341–2.CrossRefPubMed Millichap JJ, McKendrick AI, Drelichman VS. Streptococcus intermedius liver abscesses and colon cancer: a case report. West Indian Med J. 2005;54(5):341–2.CrossRefPubMed
21.
go back to reference Masood U, Sharma A, Lowe D, Khan R, Manocha D. Colorectal cancer associated with Streptococcus anginosus bacteremia and liver abscesses. Gastroenterology. 2016;10:769–74. Masood U, Sharma A, Lowe D, Khan R, Manocha D. Colorectal cancer associated with Streptococcus anginosus bacteremia and liver abscesses. Gastroenterology. 2016;10:769–74.
22.
go back to reference Tzur T, Liberman S, Felzenstein I, Cohen R, Rivkind AI, Almogy G. Liver abscesses caused by Streptococcus milleri: an uncommon presenting sign of silent colonic cancer. Isr Med Assoc J. 2003;5(3):206–7.PubMed Tzur T, Liberman S, Felzenstein I, Cohen R, Rivkind AI, Almogy G. Liver abscesses caused by Streptococcus milleri: an uncommon presenting sign of silent colonic cancer. Isr Med Assoc J. 2003;5(3):206–7.PubMed
23.
go back to reference Burnett-Hartman AN, Newcomb PA, Potter JD. Infectious agents and colorectal cancer: a review of Helicobacter pylori, Streptococcus bovis, JC virus, and human papillomavirus. Cancer Epidemiol Biomarkers Prev. 2008;17:2970.CrossRefPubMedPubMedCentral Burnett-Hartman AN, Newcomb PA, Potter JD. Infectious agents and colorectal cancer: a review of Helicobacter pylori, Streptococcus bovis, JC virus, and human papillomavirus. Cancer Epidemiol Biomarkers Prev. 2008;17:2970.CrossRefPubMedPubMedCentral
24.
go back to reference Kao WY, Hwang CY, Chang YT, et al. Cancer risk in patients with pyogenic liver abscess: a nationwide cohort study. Aliment Pharmacol Ther. 2012;36:467.CrossRefPubMed Kao WY, Hwang CY, Chang YT, et al. Cancer risk in patients with pyogenic liver abscess: a nationwide cohort study. Aliment Pharmacol Ther. 2012;36:467.CrossRefPubMed
Metadata
Title
Bacteremia from streptococcus constellatus revealing a gastrointestinal stromal tumor
Authors
Salvatore Chessa
Elena Belfiori
Giulia Mandis
Enrico Urru
Giovanna Manconi
Angelo Scuteri
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Gut Pathogens / Issue 1/2024
Electronic ISSN: 1757-4749
DOI
https://doi.org/10.1186/s13099-023-00593-6

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