Colonic Lesions in Patients with Enterococcal Endocarditis. (4th October 2017)

• Record Type: Journal Article
• Authors: Sengodan, Prasanna; Thota, Prashanthi; Asadi, Tannaz; Gordon, Steven; Gopalakrishna, Kv; Shrestha, Nabin
• Is Part Of: Open forum infectious diseases. Volume 4(2017)Supplement 1
• Page Start: S551
• Page End: S551
• Publication Date: 2017-10-04
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofx163.1432
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Current guidelines recommend that patients with either Streptococcus gallolyticus bacteremia or infective endocarditis (IE) should undergo colonoscopy to determine whether malignancy or other mucosal lesions are present. Although S. gallolyticus is the classically described microorganism for colonic neoplasm-associated IE, enterococci, E. coli, Listeria and clostridia have also been implicated in case reports. There is no large series that has described colonic abnormalities in patients with IE Methods: The Cleveland Clinic Infective Endocarditis Registry was utilized to identify all adult cases of enterococcal IE as defined by the Duke criteria. Patients were divided into those who had a colonoscopy within a year of admission for IE, and those who did not. Demographic and clinical characteristics were collected by retrospective chart review. Results: Two hundred and two patients with enterococcal IE were identified. Mean (SD) patient age was 63 (16) years, of whom 35 (17%) were below 50 years of age. One hundred and twenty-seven (63%) were males. Forty-three patients (21%) had a colonoscopy done within a year of diagnosis of IE, of whom x (%) were below 50 years of age. There were no significant differences between patients who had colonoscopy and those who did not. Thirty (70%) of 43 patients who underwent colonoscopy had at least one significant colonoscopy finding: 15 (35%) had colonic diverticular disease, 19 (44%) had polyps, 2 (5%) had an adenoma, 2 (5%) had colorectal cancer (CRC), 3 (7%) had ulcerations, 3 (7%) had inflamed mucosa, and 1 (2%) had AVM. In addition to the 2 patients with CRC, 8 (4%) had a history of colon cancer. There were no significant associations between the examined clinical factors and the finding of significant colonic lesions Conclusion: Seventy percent of patients with enterococcal IE who had colonoscopy within a year of admission for IE had at least one significant colonoscopy finding. The high incidence of CRC in patients with enterococcal endocarditis is not reported in literature and warrants further research to identify a possible causal association Disclosures: All authors: No reported disclosures.