What is the next step following a positive blood culture indicative of Strep bovis?

A positive blood culture for Streptococcus bovis is particularly significant because this bacterium is often associated with various gastrointestinal tract abnormalities, including malignancies such as colon cancer. Therefore, following the identification of S. bovis in a blood culture, it's crucial to evaluate the gastrointestinal tract for potential underlying issues.

Scheduling a colonoscopy is the appropriate next step as it allows for direct visualization of the colon and the identification of any lesions or abnormalities that may explain the presence of S. bovis in the bloodstream. Early detection of any lesions can facilitate timely intervention, which is essential for improving patient outcomes.

In contrast, while initiating intravenous antibiotics is important in the management of a bacteremia, it does not address the need to investigate the underlying cause associated with S. bovis. A CT scan would not be the immediate step taken; a colonoscopy provides a direct means of diagnosing potential bowel pathology. Referring the patient to hematology would not be relevant in this context, as the issue at hand relates primarily to the gastrointestinal tract and its potential abnormalities.