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ARTICLE |

Carcinoma of the Colon Presenting as Pyogenic Arthritis FREE

Leonard J. Lyon, MD; Michael A. Nevins, MD
[+] Author Affiliations

Reprint requests to Department of Medical Education, Bergen Pines County Hospital, Paramus, NJ 07652 (Dr Lyon).


JAMA. 1979;241(19):2060-2060. doi:10.1001/jama.1979.03290450058026
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BACTERIAL endocarditis caused by enteric organisms such as Streptococcus bovis may be the initial manifestation of occult colonic neoplasm.1 Like bacterial endocarditis, pyogenic arthritis frequently results from bacteremia. A patient who had pyogenic arthritis caused by another intestinal organism, group G Streptococcus, ultimately proved to have carcinoma of the colon.

Report of a Case  A 53-year-old woman who had been in good health except for obesity and chronic osteoarthritis of the left knee had acute pain and swelling of the left knee. When culture of the joint aspirate grew β-hemolytic Streptococcus, later identified as belonging to Lancefield group G, she was hospitalized for further examination and therapy. The patient denied all gastrointestinal symptoms.On physical examination she was afebrile. There were no abnormalities except for obesity and signs of acute inflammation of the left knee. Blood cultures were negative. The patient received 20 million units of intravenous, aqueous penicillin

REFERENCES

Klein RS, Recco RA, Catalano MT, et al:  Association of Streptococcus bovis with carcinoma of the colon . N Engl J Med 297:800-803, 1977;.
Douglas GW, Levin RH, Sokoloff L:  Infectious arthritis complicating neoplastic disease . N Engl J Med 270:299-302, 1964;.
Duma RJ, Weinberg AN, Medrek TF, et al:  Streptococcal infections: A bacteriologic and clinical study of streptococcal bacteremia . Medicine 48:87-127, 1969;.
Armstrong D, Blevins A, Louria DB, et al:  Group B, C and G streptococcal infections in a cancer hospital . Ann NY Acad Sci 174:511-522, 1970;.
Keusch GT:  Opportunistic infections in colon carcinoma . Am J Clin Nutr 27:1481-1485, 1974;.
Reinarz JA, Sanford JP:  Human infections caused by non-group A or D streptococci . Medicine 44:81-96, 1965;.

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Klein RS, Recco RA, Catalano MT, et al:  Association of Streptococcus bovis with carcinoma of the colon . N Engl J Med 297:800-803, 1977;.
Douglas GW, Levin RH, Sokoloff L:  Infectious arthritis complicating neoplastic disease . N Engl J Med 270:299-302, 1964;.
Duma RJ, Weinberg AN, Medrek TF, et al:  Streptococcal infections: A bacteriologic and clinical study of streptococcal bacteremia . Medicine 48:87-127, 1969;.
Armstrong D, Blevins A, Louria DB, et al:  Group B, C and G streptococcal infections in a cancer hospital . Ann NY Acad Sci 174:511-522, 1970;.
Keusch GT:  Opportunistic infections in colon carcinoma . Am J Clin Nutr 27:1481-1485, 1974;.
Reinarz JA, Sanford JP:  Human infections caused by non-group A or D streptococci . Medicine 44:81-96, 1965;.
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