Streptococcus gallolyticus a rare entity: Case report pointing out its importance and its association with colorectal cancer and infective endocarditis
Dr. Anu Sharma, Dr. Sonal Agarwal, Dr. DP Danave, Dr. KV Ingole
This case report describe 75 years old male admitted to the hospital with complaints of high grade fever, pain in abdomen, joint pain. Patient was self-medicating himself from past 5 years with pain killers twice a day for joint pain. Blood sample was send for culture and sensitivity before administration of antibiotics, per abdominal examination showed marked guarding and rigidity, CXR showed B/L patchy pneumonitis and pleural effusion on left side. On chest auscultation murmurs were heard. 2D echo revealed mitral valve vegetation. Patient was diagnosed for perforation peritonitis as per all parameters and emergency exploratory laparotomy was performed, on opening peritoneum yellow fluid was seen in the peritoneal cavity and on exploration circular perforation was seen along pylorus of stomach, fluid was collected from peritoneal cavity and send for microbiological evaluation. On culture smear both blood and peritoneal fluid showed growth of gram positive cocci were seen and identified as Streptococcus gallolyticus subspecies gallolyticus using Vitek-2 compact. Patient was treated with penicillin and ceftriaxone and was discharge on 15 days. On follow up colonoscopy was done which showed early colonic lesions in the recto-sigmoid area. The present study points out importance of Streptococcus gallolyticus subspecies gallolyticus co-relation with infective endocarditis and colorectal cancer and highlights importance of colonoscopy for early detection of CRC.