Q: For patients who develop infective endocarditis (IE) due to group D streptococci and E. faecalis, which non-cardiac procedure should be performed?
Patients who get identified as IE due to group D streptococci ((Streptococcus bovis/Streptococcus equinus complex) and E. faecalis, a colonoscopy should be performed. Colon cancer is found to be highly associated with these patients.
It is not fully clear why these bugs are highly associated with colon cancer but at least in case of group D streptococci, it is suggested that proteins presented in S. bovis biotype I bind to overexpressed ligands in colonic neoplasms. Simultaneously, S. bovis biotype I can form biofilms on collagen-rich surfaces of valve endothelium.
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