Is There a Correlation Between Streptococcus Gallolyticus Bacteremia and Infectious Colitis?

Introduction: Streptococcus gallolyticus are catalase-negative gram-positive cocci; which typically presents as bacteremia in adults with infective endocarditis or colonic neoplasms. Among hospitalized patients, the approximately 5% streptococcal bloodstream isolates originate from Streptococcus gallolyticus. Currently, there are no documented cases of infectious colitis causing Streptococcus gallolyticus bacteremia. This case presentation outlines these possible Streptococcus gallolyticus colitis. Case description/methods: Patient is a 55-year-old with known history of cocaine abuse; who was admitted after being found unresponsive by his fiancée; and subsequently requiring intubation for ventilator-dependent respiratory failure. Patient was incidentally found to have Streptococcus gallolyticus bacteremia. Patient also had episodes of hematochezia likely secondary to colitis. Patient underwent colonoscopy; which showed mucus discontinuous ulceration and erythema without bleeding and ascending colon, transverse colon, and sigmoid colon. Pathology suggested that colitis was secondary to infectious etiology rather than ischemic. Transesophageal echocardiogram did not show valvular vegetations. Patient was subsequently started on Rocephin; and subsequently transitioned to Cefdinir complete 2 weeks of antibiotic therapy under Infectious Disease guidance. Discussion: This patient presented with colitis likely secondary to infectious source (Streptococcus gallolyticus). Unfortunately, stool cultures were not obtained. This would be required to determine if infectious colitis can indeed cause Streptococcus gallolyticus bacteremia. Pathology showed signs of infectious etiology. Other common etiologies for Streptococcus gallolyticus were negative (colonoscopy did not reveal colonic mass and echocardiogram is a not revealed vegetations). The antibiotic of choice is Rocephin for treatment Streptococcus gallolyticus.