Relationship between Streptococcus gallolyticus Infective Endocarditis and Pre-Neoplastic Colorectal Lesions
- 1 Hospital Universitari Doctor Josep Trueta, Spain
- 2 Dirección Territorial de Radiologia i Medicina Nuclear de Girona, Spain
- 3 Centro Investigación Biomédica en Red, Spain
Abstract
Colorectal cancer is associated with Infective Endocarditis (IE) due to specific gut pathogens, such as Streptococcus gallolyticus subspecies, that use tumor presence as a point of blood entry. However, the association between Streptococcus gallolyticus related IE and pre-cancerous colorectal lesions like dysplastic adenomas is unclear. Seventy-one patients diagnosed with IE who underwent colonoscopy in the extension study during admission were included in a clinical, microbiological and imaging follow-up, between January 2008 and December 2020. Pre-cancerous lesions were divided as high and low-grade dysplasia based on World Health Organization criteria. Colorectal cancer was defined as the presence of malignant cell beyond the muscularis mucosa. Twenty-two IE patients (31%) presented colorectal lesions: 8 (36%) colorectal cancer and 14 (64%) pre-cancerous lesions [14% high degree (n = 2); 86% low degree (n = 12)]. Both, colorectal cancer (25% Vs 2%; p = 0.007) and pre-neoplastic lesions (50% Vs 2%; p<0.001) were related with higher prevalence of IE caused by Streptococcus gallolyticus. Additionally, the subgroup of low grade pre-cancerous lesions also showed this association (50% Vs 2%; p<0.001). Pre-cancerous colorectal lesions are associated with Streptococcus gallolyticus IE. These results suggest that high and low degree colorectal lesions may also act as a gateway for gut pathogens.
DOI: https://doi.org/10.3844/ajidsp.2021.88.96
Copyright: © 2021 Pau Vilardell, Sergio Moral, Josep Maria Frigola, Manel Morales, Esther Ballesteros, Xavier Salgado, Antoni Castro, Antoni Rubió, Marc Abulí and Ramon Brugada. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Keywords
- Infective Endocarditis
- Colorectal Cancer
- Streptococcus gallolyticus
- Gut Pathogens