Infective endocarditis caused by Arcanobacterium haemolyticum: a case report

Abstract

Arcanobacterium haemolyticum is an organism that commonly causes pharyngitis and wound infections. It does not usually cause systemic invasive disease. The organism presents a difficult diagnostic problem because the Clinical Microbiology laboratory has a propensity to view them as diphtheroid organisms of the Corynebacterium species, thus contaminants or normal flora. We describe a case of a 21-year-old female who had endocarditis with cerebral emboli due to Arcanobacterium haemolyticum. This rare condition is associated with significant mortality and to the best of our knowledge; this is the first successfully treated case of A. haemolyticum endocarditis complicated by embolic phenomenon.

Bacteriological characteristics of Arcanobacterium haemolyticum isolated from seven patients with skin and soft-tissue infections

“…It was first described in 1946 and was reported as a causative agent of acute pharyngitis and skin lesions (Maclean et al, 1946), and was considered a pathogen, causing wound infections and pharyngitis (Miller et al, 1986;Karpathios et al, 1992;Mackenzie et al, 1995;Funke et al, 1997;Linder, 1997). In some cases, A. haemolyticum can cause septicaemia, osteomyelitis, brain abscesses and endocarditis (Jobanputra & Swain, 1975;Vargas et al, 2006;Wong et al, 2011;Brown et al, 2013). It is often difficult to identify A. haemolyticum due to its slow growth, similar appearance to Corynebacterium spp.…”

Clinically Infrequent <i>Arcanobacterium haemolyticum</i> Bacteremia Complicated by Foot Decubitus Ulcer: An Educational Reminder for Primary Care Physicians

“…It has also been recognized and isolated from immunocompromised patients, particularly those with diabetes mellitus and malignant neoplasms presenting with skin and soft tissue infection (1,2). On rare occasions, it has been reported to cause systemic deep infection, such as meningitis (3), Lemierre's syndrome (4), and endocarditis and bacteremia (5).…”

“…In clinical microbiology laboratories, laboratory technicians may encounter them as part of the normal oral flora or as contaminants due to its innocuous and Coryneform appearance (12). It is important to consider that A. haemolyticum can function as a sole pathogen or as a component of a polymicrobial infection causing systemic infection and bacteremia (5).…”

Smooth and Rough Biotypes of Arcanobacterium haemolyticum Can Be Genetically Distinguished at the Arcanolysin Locus

“…Arcanobacterium haemolyticum is a Gram-positive, β-hemolytic, pleomorphic rod that can cause a wide range of diseases in humans, from pharyngitis and wound infections in immunocompetent patients to more severe invasive diseases in immunocompromised patients [ 1 – 5 ]. It can also be rarely isolated as a pathogen in animals [ 6 , 7 ] This emerging pathogen is classified into two biotypes based on biochemical, colony morphology, hemolytic activity and disease association [ 8 , 9 ].…”