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August 6, 1982

Sequential Bacteremia and Fungemia Associated With Carcinoma of the Colon

JAMA. 1982;248(5):545-546. doi:10.1001/jama.1982.03330050029014

To the Editor.—  The association of Streptococcus bovis bacteremia and endocarditis with lesions of the gastrointestinal (GI) tract is well recognized.1 The report of multiorganism septicemia and carcinoma of the colon (1982;247:1812) was of interest because we have recently seen a patient with sequential bacteremia and fungemia who also had colonic carcinoma.

Report of a Case.—  An 84-year-old man was admitted to the Wilmington Veterans Administration Medical Center, Wilmington, Del, with a history of anorexia and weight loss for two months. Physical examination disclosed an emaciated, confused, and combative patient with evidence of severe dehydration. He was afebrile with a BP of 90/60 mm Hg and tachycardia. There was a painful swelling of the right lower leg. Results of the physical examination were otherwise normal. Laboratory studies disclosed the following results: WBC count, 21,300/cu mm, with 90% polymorphonuclear cells; hemoglobin, 9.7 mg/dL; creatinine, 2.2 mg/dL; serum urea nitrogen, 89