Streptococcus bovis endocarditis and colonic evaluation

What it is

Streptococcus bovis is one of the typical microorganisms consistent with infective endocarditis. In the Modified Duke Criteria it sits under the major criterion blood culture positive for IE, where the typical microorganisms consistent with IE from two separate blood cultures are named as five: viridans streptococci; Streptococcus bovis; the HACEK group; Staphylococcus aureus; and community-acquired enterococci, in the absence of a primary focus. In the microbiology of infective endocarditis it is given as Bovis 7%, behind Staphylococcus aureus 31%, viridans group streptococci 17%, enterococci 11% and CNST 11%, and ahead of other Strep 5%, non-HACEK gram negatives 2%, fungi 2% and HACEK 2%. Streptococcus gallolyticus is the other name written for it.

How it presents

One described patient is a 49-year-old man with a 3-week history of fever, weight loss and anorexia, who also reports aches. He has no cough and no SOB, and a 15-pack-year smoking history. His temperature is 38.9 C (102 F), blood pressure 120/76 mmHg, pulse 90/min and respirations 16/min. The lungs are clear to auscultation and the rest of the physical examination is unremarkable. Blood cultures grew Streptococcus gallolyticus, and the echocardiogram reveals vegetations on the mitral valve.

A second described patient is a 40-year-old man brought to the hospital because of fever, with a history of IV drug use and a systolic murmur at the lower left sternal border, whose blood grew Streptococcus bovis and whose echo confirmed infective endocarditis.