SciELO - Scientific Electronic Library Online

 
vol.13 número3Adenoma seroso oligoquístico do pâncreas: a propósito de um caso clínicoObstrução duodenal secundária a gastrostomia percutânea: instantâneo endoscópico índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

  • Não possue artigos similaresSimilares em SciELO

Compartilhar


Jornal Português de Gastrenterologia

versão impressa ISSN 0872-8178

J Port Gastrenterol. v.13 n.3 Lisboa maio 2006

 

Streptococcus Gallolyticus Bacteraemia associated with colonic adenomatous polyps

 

A. Murinello1, P. Mendonça1, C. Ho1, P. Tavares1, H. Peres1, R. Rio Tinto2, A. Morbey1, C. Campos1, A. Lázaro1, A. Milheiro, M. J. Arias, J. Oliveira1, S. Braz1

 

Resumo

A bacteriémia por Streptococcus gallolyticus associa-se frequentemente ao carcinoma colorrectal, tornando obrigatória a colonoscopia nestas situações. A endocardite bacteriana e a artrite séptica são também comuns neste tipo de bacteriémias. Tem sido levantada a hipótese das bactérias intestinais poderem ter um papel promotor de hiperproliferação celular aberrante em lesões cólicas pré-neoplásicas, aparentemente devido a processos inflamatórios crónicos e produção de metabolitos carcinogénicos. Os autores apresentam o caso dum doente com vários pólipos adenomatosos tubulares do cólon direito, em dois dos quais se demonstrou uma área de displasia de alto grau adjacente a zona de colite infecciosa bacteriana, associados a quadro clínico de infecção sistémica por Streptococcus gallolyticus e artrite do tornozelo.

 

Summary

Bacteraemia due to Streptococcus gallolyticus is frequently associated with colorectal carcinoma, making evaluation of the gastrointestinal tract by colonoscopy obligatory in such cases. Bacterial endocarditis and purulent arthritis are also common in patients with these bacteraemias. Intestinal bacteria could behave as promoters of aberrant hyperproliferative behaviour in preneoplastic colorectal lesions, apparently due to chronic inflammatory processes and production of carcinogenic metabolites. The authors treated a patient with several tubular adenomatous polyps of the right colon, two of which showed areas of high-grade dysplasia adjacent to areas of infectious bacterial colitis associated with Streptococcus gallolyticus bacteraemia and unilateral ankle arthritis.

 

Texto Completo disponível apenas em PDF

Full text only available in PDF format

 

 

Bibliografia

1. Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries with special reference to dietary practice. nt J Cancer 1975; 15: 617-31.        [ Links ]

2. Parsonnet J. Bacterial infection as a cause of cancer. Environ Health Perspect 1995; 103: 263-8.

3. Hill MJ, Drasar BS, Hawksworth G, Aries V, Crowther JS, Williams RE. Bacteria and etiology of cancer of large bowel. Lancet 1970; i: 95-100.

4. Ellmerich S, Scholler M, Duranton B, Gossé F, Galluser M, Klein JP, et al. Promotion of intestinal carcinogenesis by Streptococcus bovis. Carcinogenesis 2000; 21: 753-6.

5. Schlegel L, Grimont F, Grimont PA, Bouvet A. New group D streptococcal species. Indian J Med Res 2004; 119: 252-6.

6. Burns CA, McCaughey R, Lauter CB. The association of Streptococcus bovis carriage and colon neoplasia: possible relationship with polyps and their premalignant potential. Am J Gastrenterol 1985; 80: 42-6.

7. Reynolds JG, Silva E, McCormack WH. Association of Streptococcus bovis bacteraemia with bowel disease. J Clin Microbiol 1983; 17: 696-7.

8. Klein RS, Catalano MT, Edberg SC, Casey JI, Steigbigel NH. Streptococcus bovis septicaemia and carcinoma of the colon. Ann Int Med 1979; 91: 560-2.

9. Klein RS, Recco RA, Catalano MT, Edberg SC, Casey JL, Steigbrigel NH. Association of Streptococcus bovis with carcinoma of the colon. New Engl J Med 1977; 297: 800-2.

10. Leport C, Bure A, Leport J, Vilde JL. ncidence of colonic lesions in Streptococcus bovis and Enterococcus endocarditis. The Lancet 1987; 1: 748

11. Beebe JL, Koneman EW. Recovery of uncommon bacteria from blood: association with neoplasic disease. Clin Microbiol Rev 1995; 8: 336-56.

12. Hossenbux K, Dale BA, Walls AD, Lawrence JR. Streptococcus bovis endocarditis and colonic carcinoma: a neglected association. Brit Med J 1983; 287: 21.

13. Douglas GW, Levin RH, Sokoloff L. Infectious arthritis complicating neoplasic disease. New Engl J Med 1964; 270: 298-302.

14. Moellering RC, Watson KB, Kuntz LJ. Endocarditis due to group D Streptococci: comparison of disease caused by Streptococcus bovis with that produced by Enterococci. Am J Med 1974; 57:239-50.

15. Lyon LJ, Nevine MA. Carcinoma of the colon presenting as pyogenic arthritis. JAMA 1979; 241: 2060.

16. Murinello A, Loureiro Mª, Joana A, Van-Dunen F, Mota L, Lamarão P, et al. Carcinoma of the colon associated with purulent arthritis. Rev Gastrent Cirurg (Portuguese) 1996; XIII: 23-9.

17. Syngal S, Bandipalliam P, Boland R. Surveillance of patients at high risk for colorectal cancer. Med Clin North Amer 2005; 89: 61-84.

18. Beeching NJ, Christmas TI, Ellis-Pegler RB, Nicholson GI. Streptococcus bovis bacteremia requires rigorous exclusion of colonic neoplasia and endocarditis. Quart J Med 1985; 56: 439-40.

19. Jung HC, Eckmann L, Yan S-K, Panja A, Fierer J, Mozycka-Wroblenska E, et al. Adistinct array of proinflammatory cytokines is expressed in human colon epithelial cells in response to bacterial invasion. J Clin Invest 1995; 95: 55-65.

20. Hirota K, Osawa R, Nemoto K, Ono T, Micycke Y. Highly expressed human syalic Lewis x antigen on cell surface of Streptococcus gallolyticcus. The Lancet 1996; 347: 760.

21. Ellmerich S, Djouder N, Scholler M, Klein JP. Production of cytokines by monocytes, epithelial and endothelial cells activated by Streptococcus bovis. Cytokine 2000; 12: 26-31.

22. Cheung AL, Koomey JM, Lee S, Jaffe EA, Fischetti VA. Recombinant human tumor necrosis factor alpha promotes adherence of Staphylococcus aureus to cultured human epitheliod cells. Infect Immunolog 1991; 59: 3827-31.

23. Wancke CA, Bistrian B. Recombinant human tumour necrosis factor and recombinant murine interleukin-1 alter the binding of Escherichia coli to intestine, mucin glycoprotein, and the HT29-C1 intestinal cell line. Nutrition 1997; 13: 959-64.

24. Janeway CA, Travers P. Immunobiology: The Immune System in Health and Disease. Garland Publishing Inc. New York and London. 1997.

25. Oshima H, Bartsch H. Chronic infections and inflammatory processes as cancer risk factors: possible role of nitric oxide in carcinogenesis. Mutat Res 1994; 305: 253-64.

26. Norrby K. Interleukin-8 and "de novo" mammalian angiogenesis. Cell Prolif 1996; 29: 315-23.

27. Eisma RJ, Spiro JD, Kreutzer DL. Role of angiogenic factors: coexpression of interleukin-8 and vascular endothelial growth factor in patients with head and neck squamous carcinoma. Laryngoscope 1999; 109: 687-93.

(1) Departments of Internal Medicine 1, Pathology, Histopathology, Surgery and Gastroenterology, Curry Cabral Hospital, Lisbon, Portugal.

(2) Department of Gastroenterology, Stº Antº Capuchos Hospital, Lisbon. Portugal.

 

 

Recebido para publicação: 26/09/2005

Aceite para publicação: 15/02/2006