Enterococcal infective endocarditis is a marker of current occult or future incident colorectal neoplasia
| Autor: | Fabiana D’Amico, Sabrina Manduca, Mariano Bernardo, Lorenzo Bertolino, Rosa Zampino, Maria Paola Ursi, Eugenio D'Avenia, Roberto Andini, Arta Karruli, Emanuele Durante-Mangoni, Domenico Iossa |
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| Přispěvatelé: | Ursi, M. P., Bertolino, L., Andini, R., D'Amico, F., Iossa, D., Karruli, A., D'Avenia, E., Manduca, S., Bernardo, M., Zampino, R., Durante-Mangoni, E. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer Enterococci Colonoscopy 030204 cardiovascular system & hematology Single Center Gastroenterology 03 medical and health sciences Anticoagulation 0302 clinical medicine Internal medicine Internal Medicine Medicine Endocarditis Humans Colorectal neoplasia 030212 general & internal medicine Endocarditi Adverse effect Retrospective Studies medicine.diagnostic_test business.industry Cancer Endocarditis Bacterial medicine.disease Occult Infective endocarditis S. gallolyticus business Colorectal Neoplasms |
| Popis: | Background : Few studies suggest an association between Enterococcal infective endocarditis (EIE) and colorectal disease, including colorectal neoplasia (CRN) and colorectal cancer (CRC). In this study, we analyze differences in prevalence, risk factors and outcome of CRN and CRC between EIE and Streptococcus gallolyticus infective endocarditis (SGIE). Methods : Single center, observational study of 166 patients with definite EIE or SGIE. Clinical data were collected prospectively in a standardized IE protocol. Colonoscopy data were collected retrospectively on 90 patients. Results : 85 patients had EIE, 81 SGIE. EIE patients had a higher rate of prior cancer (20% vs 6%) and health-care associated infection (12% vs 1%), but similar mortality than SGIE. Colonoscopy performed in 90 patients showed intestinal diseases in 30 of 42 (71%) EIE patients vs. 40 of 48 (83%) SGIE patients (p = 0.174), with a predominance of CRN. Among 78 patients who underwent colonoscopy after IE diagnosis, no difference between EIE and SGIE was observed in the rate of non-neoplastic lesions (48% vs 47%), benign (32% vs 40%) or malignant (13% vs 15%) neoplastic lesions. Adverse events during colonoscopy were uncommon, although a careful handling of anticoagulation was required. Conclusions : EIE seems to be associated with colorectal disease, including colorectal neoplasia and colorectal cancer, to the same extent as SGIE. EIE should be considered a marker of colorectal neoplasia, even in patients with a clear health-care related acquisition. Colonoscopy is generally safe in EIE patients, and should be considered to early diagnose and treat colorectal disease. |
| Databáze: | OpenAIRE |
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