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.

Zusammenfassung

Wir berichten über den Fall eines 52-jährigen, zuvor vollständig gesunden, Patienten, der sich mit Fieber und unklaren Leberläsionen in unserem Hause vorstellte. Der initiale Verdacht von Lebermetastasen bestätigte sich nicht, stattdessen zeigten sich multiple Leberabszesse. Mikrobiologisch zeigte sich Streptococcus intermedius als Ursache der Leberabszesse. Die weitere Diagnostik ergab einen im Magenkorpus gelegenen gastrointestinalen Stromatumor (GIST) als Eintrittspforte für die Bakteriämie. Nach antibiotischer Sanierung und operativer Resektion des GIST erholte sich der Patient rasch. Der Fall zeigt die seltene Symptomkonstellation eines GIST mit klinischer Erstmanifestation durch die Entwicklung von Leberabszessen.

Schlüsselwörter

gastrointestinaler Stromatumor (GIST) - Streptococcus intermedius - Leberabszess - Bakteriämie - Drainage - Penicillin G

Key words

gastrointestinal stromal tumor (GIST) - Streptococcus intermedius - liver abscess - bacteremia - drainage - penicillin G

^* Equally contributing authors.

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