<i>Enterococcus Faecalis</i> Infective Endocarditis and Colorectal Carcinoma: Case of New Association Gaining Ground
Bibliographic record
Abstract
Mostly Streptococcus bovis ( S. bovis ) bacteremia and endocarditis (60%) has been found to be associated with underlying colorectal cancer (CRC). Enterococcus faecalis ( E. faecalis ) bacteremia and endocarditis has no identifiable source in most of the cases. E. faecalis is part of normal gut flora that can translocate through the intestine and cause the systemic infection. With any intestinal lesion or tumor, the barrier is breached and the gut flora like E. faecalis can translocate and cause infection. A 55-years-old male known to have non-ischemic cardiomyopathy with implantation of automated implantable cardioverter defibrillator (AICD) and atrial fibrillation presented with weight loss, fever and back pain. He was diagnosed to have E. faecalis bacteremia and subsequent endocarditis and osteomyelitis of T7 - T8 and L4 - L5 vertebrae. He underwent colonoscopy for screening of malignancy because of his age and presenting symptoms suggestive of one. The colonoscopy found pedunculated polyp in sigmoid colon, and after biopsy the histology revealed an invasive well differentiated mucinous adenocarcinoma, with focal squamous differentiation. He underwent removal of AICD and antibiotic treatment for infective endocarditis and osteomyelitis. He underwent sigmoid colectomy with pathology of removed specimen showing adenocarcinoma with negative margins and lymph nodes. In many of the patients with E. faecalis endocarditis, if identifiable the source is genitourinary tract. But in most of the cases the source of E. faecalis bacteremia is unidentified. There is some evidence to suggest that in patients with unidentified source, colonoscopy may reveal a hidden early stage CRC or adenoma. We conclude that in cases of E. faecalis bacteremia and endocarditis with unidentified source, colonoscopy should be considered if feasible to rule out the diagnosis of CRC. Gastroenterol Res. 2018;11(3):238-240 doi: https://doi.org/10.14740/gr996w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".