Streptococcus gallolyticus (SG) - among other bacterial infections - is associated with colorectal malignancy and adenoma. It is reported that patients with SG bacteraemia have a concomitant colorectal tumour in 25-80% of cases. We present a case of a patient with complications of this septicaemia associated with a rectal adenocarcinoma, as an example of this important radiological and clinical correlation. Teaching Point: Always screen for primary colorectal malignancy in a patient with malignancy-associated bacterial infection.