STREPTOCOCCUS-BOVIS BACTEREMIA AND ENDOCA RDITIS IN PATIENTS WITH LIVER-DISEASE WITHOUT EVIDENCE OF COLONIC DISEASE

The association of Streptococcus bovis bacteremia and endocarditis wit h colonic pathology, mainly neoplastic, is well known, Its relationshi p with liver disease without evidence of gastrointestinal disease has been rarely described, To analyze the association between S. bovis inf ection and liver disease, positive blood cultures for this microrganis m in hospitalized patients in the Internal Medicine and Gastroenterolo gy Departments from December 1993 until October 1995, have been review ed, Three cases of S. bovis infection (one bacteremia, two endocarditi s) were found. Alcoholic liver disease was diagnosed in all three pati ents, with associated hepatitis C virus in one of them, Colonic pathol ogy was excluded by colonoscopy and/or barium enema, Other gastrointes tinal disorders were excluded by means of gastroscopy, barium gastroin testinal study and abdominal ultrasonography. Antibiotic therapy was b ased in betalactamics, with associated aminoglycoside in two cases. On e patient needed aortic and mitral valve replacement and another one n eeded orthotopic liver trasplantation, No new gastrointestinal patholo gy emerged in the follow-up (5-23 months), Cases of S. bovis bacteremi a and endocarditis should be screened not also for colonic pathology, but also for liver disease, particularly in alcoholics.