Prevalence of liver disease in patients with Streptococcus bovis bacteraemia.
BACKGROUND
The relationship between Streptococcus bovis bacteraemia and gastrointestinal disease (mainly colon cancer) is well known. Patients with advanced liver disease are prone to bacteraemia. Less attention has been paid to the association between liver disease and Streptococcus bovis bacteraemia in the literature.


OBJECTIVE
To evaluate the prevalence of liver disease in patients with S. bovis bacteraemia.


METHODS
Twenty-two episodes of S. bovis bacteraemia in 20 adults (13 males and seven females, with a median age of 61 years, range 32-94 years) were detected in a single hospital over a 7-year period. Ten of them had endocarditis. Patients' clinical records were reviewed, with special focus on underlying liver and gastrointestinal disease.


RESULTS
Eleven patients (55%) had a chronic liver disease. Nine of them were cirrhotics. Ten patients had a history of chronic alcohol abuse, and four patients had hepatitis C virus antibodies (associated with alcohol abuse in three cases). Large bowel disease was present in six out of 13 evaluable patients (adenocarcinoma in three cases). Patients with liver disease were younger than patients without it. Mortality related to S. bovis bacteraemia was particularly high among patients with advanced liver disease (Child-Pugh state C). Bacteraemia recurred two times in one alcoholic cirrhotic, who was diagnosed as having a Dukes-B colon cancer 4.5 years after the first episode of S. bovis bacteraemia.


CONCLUSIONS
In our area, S. bovis bacteraemia is frequently associated with chronic liver disease. Liver disease may be a predisposing factor for S. bovis bacteraemia.
Gonzlez-Quintela
A
A
Department of Internal Medicine, Complejo Hospitalario Universitario, Santiago, Spain.
Martínez-Rey
C
C
Castroagudín
J F
JF
Rajo-Iglesias
M C
MC
Domínguez-Santalla
M J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D016470:Bacteremia / Q000209:etiology* / Q000382:microbiology; D003108:Colonic Diseases / Q000150:complications; D004198:Disease Susceptibility; D004696:Endocarditis / Q000209:etiology / Q000382:microbiology; D005260:Female; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008107:Liver Diseases / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013290:Streptococcal Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D016985:Streptococcus bovis
D018937:Hepatitis C Antibodies