Gastrointestinal stromal tumor as entry port for S. intermedius causing bacteremia and multiple liver abscesses. Case report and review of literature.

Abstract

We report a case of a previously healthy 52-year-old man who presented with fever and liver lesions suspicious for metastatic disease, which proved subsequently to be abscesses. Further workup revealed a gastrointestinal stromal tumor (GIST) in the gastric corpus as entry port to Streptococcus intermedius-associated bacteremia and liver abscesses. After antibiotic treatment and surgical resection of the tumor, the patient recovered well. This unusual case indicates that gastrointestinal stromal tumors can remain undetected until they cause a life threatening infection. A review of recent literature pertaining to GIST and liver abscesses follows.

The Clinical View on Streptococcus anginosus Group – Opportunistic Pathogens Coming Out of Hiding

“…tumor, diverticulitis of the colon, adenocarcinoma of the colon, acute cholangitis sump syndrome, chronic granulomatous diseaseHiura et al, 2000;Millichap et al, 2005;Wagner et al, 2006;Neumayr et al, 2010;Falcone et al, 2012;Livingston and Perez-Colon, 2014;Benou et al, 2016;Mayor et al, 2016;Parthvi et al, 2017;Reddy et al, 2018;Hanna et al, 2020 S. constellatus 5 5 case reports Diverticulitis of the sigmoid colon and subsequent hematogenous spread of bacteria, infection associated with gastric adenocarcinomaAkuzawa et al, 2017;Dsouza et al, 2019;Wong, et al, 2019;Chrastek et al, 2020;Navarrete et al, 2020 …”

A Case of Streptococcus intermedius Abscess Within a Malignant Neck Mass and Review of the Literature

“…The remainder of the cases identified in our literature search were cancer patients who developed S. intermedius abscesses but who had not received radiation treatment. [8][9][10][11][12][13][14][15][16][17][18][19][20][21] One of these patients, like our patient, had tonsillar squamous cell carcinoma; however, this patient presented with a neck abscess before cancer diagnosis. 12…”

“…Only 2 articles were specifically patients who had previously received radiation therapy 6,7 . For the articles by Miyamoto et al, 8 Yuba et al, 9 Benou et al, 10 and Ishihara et al, 11 only the abstracts were available so data appearing in the table were extracted from the abstracts. Data related to patient demographics, cancer type, abscess location, treatment, and outcome were collected and summarized in Table 1.…”