Two patients with colonic adenocarcinoma and Streptococcus bovis endocarditis suggested a possible association between the two. Non-enterococcal Group D streptococci were isolated from fecal cultures of 11 of 105 controls, 35 of 63 patients with carcinoma of the colon, seven of 25 with inflammatory bowel disease, four of 21 with non-colonic neoplasms and five of 37 with other gastrointestinal disorders. All such streptococci examined for lactose fermentation were S. bovis. The prevalence of S. bovis in fecal cultures from patients with carcinoma of the colon was significantly increased (P<0.001) as compared to that in controls, and also to all other groups (P<0.001). No other group had results significantly different from those of controls (P>0.05) although patients with inflammatory bowel disease were more frequently carriers. The carrier state was unrelated to age, hospitalization status, colonic stasis, gastrointestinal bleeding or recent barium-enema examination. The implications of this association are unknown. (N Engl J Med 297:800–802, 1977) Streptococcus bovis, a Group D non-enterococcal organism, has recently received increased attention, especially for its role as a cause of infective endocarditis.1 2 3 4 5 However, the presence of S. bovis in the indigenous flora of man has not been thoroughly explored. The discovery of adenocarcinoma of the colon in two patients with S. bovis endocarditis prompted a study of the carrier rate of this organism and its possible association with carcinoma of the colon. Materials and Methods Group D non-enterococcal streptococci were identified according to the method of Facklam6 on the basis of colonial morphology, Gram stain, growth in 40 per cent.
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