An unusual case of infective endocarditis

Abstract

A rare case of Corynebacterium striatum endocarditis on a bioprosthetic aortic valve replacement, treated medically, is reported. The presentation was subacute, and initially endocarditis screening was negative. Because of the failure of symptoms to settle further screening was performed which confirmed the organism in several sets of blood cultures. This emphasises the importance of persistent screening for endocarditis if the history raises any suspicion of this potentially serious infection, especially in the presence of prosthetic valves.

Corynebacterium striatum Cardiovascular Implantable Electronic Device Infection

“…7,11 Treatment of complicated CIED lead infection, with removal of the CIED in combination with at least 4 weeks of targeted antibiotic therapy, while monitoring for signs of embolic occurrences, as suggested in prior publications, is supported by our results. However, high grade and persistent bacteremia should warrant investigation of cardiac devices.…”

“…11 Most of CIED infections are caused by Staphylococcus aureus and coagulase-negative Staphylococcus species. C. striatum is uncommonly associated with device-related infections due to a low potential to adhere to host surfaces and its lack of characterized virulence factors.…”

First report of prosthetic mitral valve endocarditis due to Corynebacterium striatum: Successful medical treatment. Case report and literature review

“…Much less is known of prosthetic valve endocarditis caused by nondiphtheriae corynebacteria, and only two cases, both affecting the aortic valve, have been reported. 3,4 In our patient during the first admission the C. striatum bacteraemia was probably a catheter related nosocomial bacteraemia. Considering his pre-existing valvular disease it may be hypothesized that this bacteraemia was the initiating event for the endocarditis diagnosed at his second admission.…”

Corynebacterium minutissimum endocarditis: A case report and review

“…The clinical presentation was typical in most cases, but in some reports, presentation was mimicked other systemic diseases, such as systemic vasculitis, 12 or atypical symptoms of severe infection such as lethargy and malaise. 13 Most patients had severe underlying disease such as chronic renal failure, 16 paraplegia, 17 diabetes mellitus, congestive heart failure, 18 history of infectious endocarditis or medical intervention involving such as placement of femoral graft, 16 ventriculostriatal shunt, 17 patent ductus arteriosus, 21 pacemaker implantation, 19 femoral access for coronary angiography 11 neurosurgical operation of aneurysm of the CNS, 14 but patients with negative history have also been reported, 15 including our case. Antimicrobial chemotherapy and/or surgery resulted in successful outcome in 15 out of 19 patients, while 4 patients succumbed.…”