AUTHOR=An Yanhua , Cao Qiumei , Liu Yixin , Lei Luping , Wang Dawei , Yang Yanjie , Kong Weijie , An Dali , Liu Dan 

TITLE=Sigmoido-vesical fistula secondary to sigmoid colon cancer presenting as urinary tract infection with Lactococcus lactis: A case report

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1054978

DOI=10.3389/fonc.2023.1054978

ISSN=2234-943X

ABSTRACT=Colovesical fistula is a pathological communication between the colon and bladder. The symptoms include pneumaturia, fecaluria, and lower urinary tract infection. Urine cultures performed in patients with colovesical fistulas usually show growth of Escherichia coli or mixed growth of bowel organisms. Urinary tract infections caused by Lactococcus lactis are very rare, as it is rarely considered pathogenic in humans. We report the case of a 70-year-old woman who presented with symptoms of recurrent urinary tract infection. Clean mid-stream urine cultures were positive for L. lactis. The microbial identification was done by VITEK 2 compact system (Biomerieux Ltd., France). On admission, poor glycemic control was considered the probable cause of urinary tract infection, the initial treatments appeared effective. On the day 10 of admission, sudden worsening of symptoms were observed despite ongoing treatment, further work-up was then considered. Abdominopelvic computed tomography (CT) revealed focal thickening of the bladder wall and gas in the bladder. Cystoscopic examination and colonoscopy revealed sigmoid colon cancer and sigmoido-vesical fistula. Laparoscopic surgical treatment was done. The patient recovered and was discharged 3 week later without chemoradiotherapy. On follow-up after 6 months, the patient was asymptomatic and stable. To our knowledge, this is the second reported case of L. lactis infection of the urinary tract and the first reported case in adults.  L. lactis infection usually indicates the presence of serious underlying diseases such as malignancies, uncontrolled diabetes, and organ failure.