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Lee, Yoo, Hwang, Kim, Uh, and Yoon: A Case of Streptococcus gallolyticus subsp. gallolyticus Bacteremia in Liver Cirrhosis
Original Article

Lab Med Online 2017;7(3):157-160.

Published online: 17 July 2017

DOI: https://doi.org/10.3343/lmo.2017.7.3.157

A Case of Streptococcus gallolyticus subsp. gallolyticus Bacteremia in Liver Cirrhosis

Saejin Lee, M.D., Gilsung Yoo, M.D., Gyu Yul Hwang, M.S., Juwon Kim, M.D., Young Uh, M.D., Kap Jun Yoon, M.D.

Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Corresponding author: Young Uh Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea Tel: +82-33-741-1592, Fax: +82-33-731-0506, E-mail: u931018@yonsei.ac.kr

Received 29 October 201624 November 2016       Accepted 24 November 2016

Copyright © 2017 The Korean Society for Laboratory Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Streptococcus bovis bacteremia in humans has been traditionally associated with infective endocarditis, colorectal cancer, and liver cirrhosis. S. bovis strains were previously categorized by biotype, but since the 2000s, they have been reclassified by DNA homology. We report a case of S. gallolyticus subsp. gallolyticus bacteremia, identified by 16S rRNA sequencing, in a patient diagnosed with liver cirrhosis. A 61-yr-old man with a history of liver cirrhosis presented to the hospital with a complaint of fever. Blood culture revealed the presence of gram-positive cocci, and the isolated organism was identified as S. bovis by the MicroScan identification kit (Beckman Coulter, USA), but as Enterococcus saccharolyticus by the Vitek 2 identification kit (bioMérieux, USA). The organism was finally confirmed as S. gallolyticus subsp. gallolyticus by 16S rRNA sequencing.

Keywords: Bacteremia, Liver cirrhosis, Streptococcus gallolyticus, 16S rRNA sequencing

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Table 1.
Comparison of biochemical characteristics between our isolate and other related species [14]
Biochemical characteristics This case∗ Streptococcus bovis Streptococcus gallolyticus subsp. gallolyticus Enterococcus saccharolyticus Streptococcus gallolyticus subsp. pasterianus
Hydrolysis of arginine - - - - -
Production of          
   β-Glucuronidase - - - - +
   α-Galactosidase + + + + v
   β-Galactosidase - - - - +
   Pyrrolidonyl arylamidase - - - + -
Acidification of          
   Lactose + + + + +
   Mannitol + - + + -
   Methyl-β-D-glucopyranoside + + + + +
   Raffinose + v + + v
   Trehalose + v + + +

∗ Biochemical reaction tested by the Vitek 2 GP kit.

Abbreviations: +, ≥80% of strains positive; -, ≤20% of strains positive; v, 21–79% of strains positive.

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