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Second look at Streptococcus sanguinis and the colon
  1. Robert Thomas1,
  2. Vineet Gupta1,
  3. Brian Kwan1,2
  1. 1Medicine, University of California San Diego Health System, San Diego, California, USA
  2. 2Medicine, VA San Diego Healthcare System, San Diego, California, USA
  1. Correspondence to Dr Vineet Gupta, v1gupta{at}


Although the link between Streptococcus bovis bacteraemia and colon cancer is well established, bacteraemia from other viridans group streptococci that commonly colonise colonic mucosa may also herald occult malignancy. We present a case of Streptococcus sanguinis bacteraemia in an elderly man with new anaemia that led to the detection and removal of a high-grade colon neoplasm. This case contributes to a growing body of literature contending that unexplained streptococcal bacteraemia merits a thorough workup that may include relatively invasive procedures such as endoscopy. Diagnostic colonoscopy provides an opportunity to prevent invasive malignancy that may outweigh bleeding and perforation risks in elderly patients.

  • colon cancer
  • valvar diseases
  • cancer intervention
  • infections
  • gi bleeding
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  • Contributors RT: Conception, design of work, wrote first draft and revisions. VG: Interpretation of data, critical revisions. BK: Interpretation of data, critical revisions. All authors approved the final version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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