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S. infantarius vs S. gallolyticus — SCE Infectious Diseases MCQ

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HardBone & Joint InfectionS. infantarius vs S. gallolyticusSCE Infectious Diseases

Blood cultures from a patient with definite infective endocarditis grow Streptococcus gallolyticus subsp. gallolyticus. He has no bowel symptoms and a recent FIT was negative. Once stable, which additional investigation remains indicated?

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Correct answer: A — Colonic evaluation for occult colorectal neoplasia

S. gallolyticus subsp. gallolyticus bacteraemia/endocarditis has a strong association with colorectal neoplasia. A negative FIT or lack of symptoms does not remove the need for colonic evaluation. The original biotype comparison encouraged clinicians to omit screening on a weakly sourced taxonomic distinction.

Reference: 2023 ESC infective endocarditis guideline: https://academic.oup.com/eurheartj/article/44/39/3948/7243107