Streptococcus bovis bacteremia as the initial presentation of carcinoma of the gallbladder.

There is a well known association between Streptococcus bovis infection and the presence of a coexisting colonic adenocarcinoma. Association of S. bovis with other malignancies has only been rarely reported. We report a 77-year-old male who presented with with Streptococcus bovis bacteremia in the setting of acute cholecystitis. Given the association of colon adenocarcinoma and Streptococcus bovis bacteremia, colonoscopy was performed prior to cholecystectomy to evaluate a possible coexisting colon neoplasm, which was negative. At cholecystectomy, the patient was found to have a carcinoma of the gallbladder, which was treated with radical cholecystectomy and periportal lymphadenectomy. This is the first case of Streptococcus bovis infection and coexisting gallbladder cancer to be reported, and highlights the need for maintenance of a high index of suspicion for malignancies other than colon cancer when patients present with Streptococcus bovis bacteremia.