Scoping review maps invasive bacterial infections and colonic tumors regionally

A scoping review of 29 studies from Latin America and the Caribbean found that invasive infections involving the Streptococcus bovis/Streptococcus equinus complex were frequently accompanied by neoplastic findings during colonic evaluation. Across 78 patients and 79 infection episodes, neoplasms were identified in 17 of the 25 studies reporting clinical or post-mortem colonic assessment, including adenocarcinoma in 11 studies and adenomas in six. The findings suggest that colonic assessment has been widely recommended after these invasive infections, although the review identified limited evidence showing how consistently such evaluations were performed or what they ultimately revealed.

The review, published in Gut Pathogens, was conducted using the Joanna Briggs Institute methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Investigators searched five bibliographic databases without date restrictions, then had pairs of reviewers independently select studies and extract data using 44 variables. They identified 210 records and included 29 studies published from 1984 through 2025. The evidence consisted of 25 case reports and four case series, making it geographically concentrated and dominated by individual clinical descriptions rather than prospective population-based studies.

Infective endocarditis was the leading clinical presentation, appearing in 19 of the 29 included studies, or 65.5%. A separate bacteremia series documented endocarditis in six of 23 episodes, while other studies described primary bacteremia without an identified source, meningitis, spontaneous bacterial peritonitis, septic arthritis, abscesses and additional systemic infections. Clinical colonic evaluation was reported in 22 studies, representing 75.9% of the evidence base. Among the 25 studies with any clinical or post-mortem colonic evaluation, neoplastic findings were documented in 17, or 68.0%. Adenocarcinoma accounted for findings in 11 studies, equivalent to 37.9% of all 29 studies, and adenomas were reported in six, or 20.7%.

Despite the frequent documentation of colonic tumors, the review found substantial gaps in regional evidence and in the implementation of recommended evaluations. Twenty-seven of the 29 studies, or 93.1%, explicitly or implicitly recommended subsequent assessment of the colon. Documented follow-up appeared more variable, particularly in institutional case series, and the available publications provided too little consistent information to estimate colonoscopy adherence, diagnostic yield, taxonomic patterns or clinical outcomes. No eligible evidence was identified in 24 of the 33 countries considered. The authors therefore call for prospective multicenter cohorts and regional registries to establish how often colonic evaluation occurs after invasive Streptococcus bovis/Streptococcus equinus complex infection, how frequently neoplasia is detected and how patients fare over time. Because the synthesis was designed to map evidence rather than combine results quantitatively, its findings characterize the regional literature but do not establish the frequency of colonic neoplasia among all patients with these infections.

Subject of Research: Regional evidence on invasive Streptococcus bovis/Streptococcus equinus complex infection and associated colonic neoplasia

Article Title: Invasive Streptococcus bovis/Streptococcus equinus complex infection and colonic neoplastic pathology in Latin America and the Caribbean: a scoping review

Article References: Ospina, J. D. U., Perez, T. A., Roldán, I. M., Vargas, D. S., Mora-Jibaja, E., Nati-Castillo, H. A., Saavedra-Torres, J. S., Hidalgo, M. J., & Izquierdo-Condoy, J. S. (2026). Invasive Streptococcus bovis/Streptococcus equinus complex infection and colonic neoplastic pathology in Latin America and the Caribbean: a scoping review. Gut Pathogens. https://doi.org/10.1186/s13099-026-00872-y

Image Credits: AI Generated

DOI: 10.1186/s13099-026-00872-y

Keywords: Streptococcus bovis, Streptococcus equinus, invasive infection, colonic neoplasia, colorectal adenocarcinoma, infective endocarditis, scoping review, Latin America, Caribbean, Invasive, Streptococcus, bovis