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Background: Corynebacterium striatum (C. striatum) is a gram-positive, anaerobic bacillus found both environmentally and in human skin and nasal mucosa flora. It is reportedly the etiologic agent of community-acquired and nosocomial diseases and is significantly associated with bacteremia and medical endovascular devices. This is the rare case of mitral valve native valve endocarditis (NVE) caused by C. striatum occurring in a young adult without underlying structural heart disease or indwelling cardiovascular medical devices successfully treated with multidisciplinary therapy., Case Presentation: The patient was a 28-year-old female with no medical history. She was transferred our hospital due to sudden onset of vertigo and vomit. A computed tomography on day 2 revealed the hydrocephalus due to the cerebellar infarction, and she underwent posterior fossa decompression for cerebellar infarction. An angiography on day 8 revealed a left vertebral artery dissection, which was suspected be the etiology. Afterwards, a sudden fever of 39 degrees developed on day 38. She was diagnosed with aspiration pneumonia and treated with ampicillin/sulbactam but was still febrile at the time of transfer for rehabilitation. Treatment continued with levofloxacin, the patient had no fever decline, and she was readmitted to our hospital. Readmission blood cultures (3/3 sets) revealed C. striatum, and an echocardiogram revealed an 11 mm long mitral valve vegetation, leading to NVE diagnosis. On the sixth illness day, cardiac failure symptoms manifested. Echocardiography revealed mitral valve rupture. She was transferred again on the 11th day of illness, during which time her mitral valve was replaced. C. striatum was detected in the vegetation. Following surgery, she returned to our hospital, and vancomycin administration continued. The patient was discharged after 31 total days of postoperative antimicrobial therapy. The patient experienced no exacerbations thereafter., Conclusions: We report the rare case of C. striatum mitral valve NVE in a young adult without structural heart disease or indwelling cardiovascular devices., Clinical Trial Number: Not applicable., (© 2024. The Author(s).)

Corynebacterium striatum occasionally causes nosocomial infections, such as catheter-related bloodstream infection and pneumonia; however, C. striatum-related infective endocarditis or septic arthritis is uncommon. We present the case of an 85-year-old woman with infective endocarditis at the native valve and septic arthritis at the native shoulder joint caused by C. striatum. The patient was admitted for a 10-day history of fever and right shoulder pain. She had no history of artificial device implantation, injury, arthrocentesis, or hospitalization. A physical examination revealed conjunctival petechiae, a systolic heart murmur, and right shoulder joint swelling. C. striatum was observed in two blood culture sets. Transesophageal echocardiography revealed vegetation in the right aortic coronary cusp. Arthrocentesis at the right shoulder aspirated pyogenic fluid and C. striatum was detected in the culture. The patient was diagnosed with infective endocarditis and septic arthritis caused by C. striatum, and ampicillin was administered based on antimicrobial susceptibility test results. The patient's condition was initially stable; however, she developed pulmonary congestion on day 56 and eventually died. An autopsy demonstrated perforation of the aortic left coronary cusp with vegetation. C. striatum may cause native valve endocarditis and native joint septic arthritis., Competing Interests: Declarations of competing interest None., (Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Corynebacterium jeikeium is a gram-positive, aerobic, pleomorphic, nonspore forming bacillus, commonly present on the skin surface. Infective endocarditis secondary to C. jeikeium most commonly affects left-sided heart valves and has a higher likelihood to require valve replacement compared to other Corynebacterium endocarditis. C. jeikeium endocarditis is extremely difficult to treat as it is characteristically resistant to penicillin, cephalosporins and aminoglycosides, and sensitivity to quinolones, macrolides, tetracyclines and rifampin is variable. Despite treatment, mortality rates as high as 33% have been reported. We hereby review the literature regarding the epidemiology, diagnosis and treatment of this deadly microorganism., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Non-diphtheriae Corynebacterium species are usually considered as contaminants of clinical specimens due to their widely environmental distribution and colonization of the human skin and mucous membranes. However, these bacteria have been increasingly recognized as agents of life-threatening infections mainly in individuals in immunosuppressive conditions. These organisms have vast variation in morphology and biochemical reaction, characteristics that make the correct identification of Corynebacterium at the species level extremely difficult using conventional phenotypic methods. The precise identification of C. amycolatum requires approaches rarely available in conventional clinical microbiology laboratories, such as API Coryne system, 16s rRNA and rpoB gene sequencing. In this setting, MALDI-TOF, a quick, accurate, and relatively unexpansive molecular technique, arises as a cost-effective alternative for characterizing these agents. Here, a rare and lethal case of endocarditis caused by C. amycolatum is presented. This is the first case of infective endocarditis due to C. amycolatum reported in Brazil., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2018 Jaqueline Abel da Rocha, Natalia Chilinque Zambão da Silva, Rafael Guaresma Garrido, Beatriz Meurer Moreira, Ianick Souto Martins.)

Background: Corynebacterium striatum is a member of the non-diphtherial corynebacteria, which are ubiquitous in nature and generally colonize the skin and mucous membranes of humans. Rarely, it causes infective endocarditis (IE). We report a case of rare left atrial bacterial vegetative mass due to C. striatum masquerading as a myxoma identified through a tortuous diagnostic process, and present a brief review of the relevant literature., Case Presentation: We present a case of 63-year-old man who presented with progressively worsening dyspnea on exertion and lower leg edema, and was diagnosed with heart failure. Transesophageal echocardiography (TEE) revealed that the left atrium was filled with a 2.7 cm × 2.6 cm mass. The patient, who had no signs of infection or related risk factors, was suspected of having a left atrial myxoma clinically. After excising the mass, the histopathology suggested thrombus with no myxocytes. Postoperatively, a fever appeared and C. striatum was isolated from the blood cultures. Although antibiotics were used, the symptoms of heart failure worsened gradually and echocardiography revealed valve vegetation. The patient underwent a second operation because of IE. Surprisingly, the mass was confirmed to be a bacterial vegetation due to C. striatum based on Gram staining at a 1000× magnification, although this was not noted on routine pathological examination of the two surgical specimens., Conclusions: Physicians should be aware of Corynebacterium in blood cultures, which cannot simply be assumed to be a contaminant. A diagnosis of IE should be suspected, particularly in high-risk patients or those with an unexplained fever. Our patient had IE due to C. striatum with no risk factors. This case supports the diagnosis of IE using a combination of pathology and etiology.

Infective endocarditis is rarely caused by Corynebacterium species. We report a unique case of Corynebacterium propinquum endocarditis in an otherwise healthy individual, and it is the first example of this organism causing culture-negative endocarditis. Conflicting clinical and microbiological data led to the use of sequencing to confirm the causative organism. This case illustrates C. propinquum as a cause of infective endocarditis, and it demonstrates the utility of ancillary molecular diagnostic techniques to identify etiologic agents in difficult cases of infective endocarditis., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Infective endocarditis (IE) in dogs with cardiac shunts has not been reported previously. However, we encountered a dog with concurrent patent ductus arteriosus (PDA) and IE. The dog was a 1-year-old, 13.9-kg female Border collie and presented with anorexia, weight loss, pyrexia (40.4 °C) and lameness. A continuous murmur with maximal intensity over the left heart base (Levine 5/6) was detected on auscultation. Echocardiography revealed a PDA and severe aortic stenosis (AS) caused by aortic-valve vegetative lesions. Corynebacterium spp. and Bacillus subtilis were isolated from blood cultures. The dog responded to aggressive antibiotic therapy, and the PDA was subsequently surgically corrected. After a series of treatments, the dog showed long-term improvement in clinical status.

Patient: Male, 23., Final Diagnosis: Corynebacterium diphtheriae endocarditis., Symptoms: Abdominal pain • cachexia • diarrhea • fever • vomiting., Medication: -., Clinical Procedure: Mitral valve replacement., Specialty: Surgery., Objective: Rare disease., Background: Although Corynebacterium diphtheriae is well known for causing diphtheria and other respiratory tract infections, in very rare cases it can lead to severe systemic disease., Case Report: This is a case of a previously healthy young man (no prosthetic valve in situ or other known congenital defect), presenting with a Corynebacterium diphtheriae infection leading to endocarditis. The patient reported no I.V. drug use, so it can be assumed that no risk factors for infective endocarditis were present., Conclusions: This report aims to raise suspicion for this specific infection in order to proceed with the right treatment as soon as possible.

Endocarditis due to Corynebacterium striatum has been rarely reported. A 78-year-old patient developed pacemaker endocarditis caused by multidrug-resistant C. striatum, complicated by vertebral osteomyelitis and epidural abscess. Daptomycin therapy successfully eradicated the bacteremia and metastatic infection. A review of the English literature on this emerging nosocomial, multidrug-resistant pathogen is included.

Prosthetic valve endocarditis (PVE) is a serious complication with potential fatal consequences, classified as early or late PVE, depending on whether typical symptoms occur within or later than 12 months from surgery. The incidence of early PVE is under 1%, but it carries high morbidity and mortality rates. There are few reported cases in literature of PVE due to Corynebacterium Jeikeium even though it is present in normal skin flora particularly in hospitalized patients. Corynebacterium species are, in fact, recognized as uncommon agents of endocarditis and little is known regarding species-specific risk factors and the outcome in this kind of endocarditis. Described is an unusual case report of a 57-year-old man who had early aortic PVE due to Corynebacterium Jeikeium infection complicated by dehiscence of the prosthesis, complete atrio-ventricular block, perforation of the interventricular septum and septic shock. Prompt diagnosis, choice of daptomycin as antibiotic therapy although it has only been approved by the European Medicine Agency (EMEA) for right-sided endocarditis and timely open heart surgery, resulted in a successful outcome.

The authors report a fatal case of Corynebacterium sp. endocarditis. Corynebacterium spp. are non-sporulating, pleomorphic Gram-positive bacilli. In particular the authors have identified a species of Corynebacterium very closely related to C striatum. This is C simulans. The authors were able to identify the genus and species using various phenotypic tests. Highlighted here is the importance of identifying diphtheroids as a significant pathogen in the appropriate setting and the need to start antibiotic therapy if this is suspected.

Corynebacterium amycolatum, a normal inhabitant of human skin, is a Gram-positive, non-spore-forming, mycolic acid-free, aerobic or facultative anaerobic bacillus. Since its description in 1988, it has only rarely been associated with infective endocarditis. This paper describes a case of infective endocarditis successfully treated by combination therapy with daptomycin and rifampicin. To the best of our knowledge, this is the first case report of C. amycolatum endocarditis from the USA successfully treated with these agents.

Objective: To report a case of Corynebacterium striatum endocarditis that was treated successfully with daptomycin plus rifampin following an unsuccessful attempt at vancomycin desensitization and failure of linezolid therapy., Case Summary: A 46-year-old woman with hemodialysis-dependent chronic renal failure was admitted for a graft-related infection. She presented with C. striatum endocarditis that was treated with daptomycin plus rifampin due to a history of allergies to vancomycin and beta-lactam antibiotics and failure of linezolid therapy. The patient received daptomycin and rifampin for a total of 6 weeks. Three months after completion of treatment, no recurrence of endocarditis was evident., Discussion: Daptomycin is a lipopeptide antibiotic, with rapid bactericidal activity. It has demonstrated efficacy in animal models of staphylococcal, streptococcal, and enterococcal endocarditis. Case reports of its activity in methicillin-resistant Staphylococcus aureus endocarditis have also been documented., Conclusions: Daptomycin, which has shown in vitro activity against C. striatum, may be a viable treatment option for patients with C. striatum endocarditis who are either allergic or refractory to traditional antibiotics.

The in vivo relevance of the paradoxical bactericidal effect (the Eagle effect) is not evident. We found in vitro a paradoxical bactericidal effect of amoxicillin on 2 strains of nontoxigenic Corynebacterium diphtheriae. Then, using an experimental rabbit model of endocarditis, we evaluated the in vivo relevance of this phenomenon. Rabbits were assigned to the following groups: no treatment (control group), continuous amoxicillin infusion simulating a dosage of 200 mg/kg/day in humans, and continuous amoxicillin infusion simulating a dosage of 20 mg/kg/day in humans. The low dosage (20 mg/kg/day) was significantly more effective than the high dosage (200 mg/kg/day) against both strains (P<.025), confirming the paradoxical bactericidal effect observed in vitro.

Corynebacterium xerosis is a rare cause of endocarditis, mainly affecting immunocompromised patients and those with predisposing cardiovascular lesions. While often considered a blood culture contaminant, serious infections by this organism have been reported. C. xerosis endocarditis is associated with poor outcomes that could be potentially improved by early recognition and treatment., (Copyright 2003 Elsevier Inc.)

The nondiphtheriae corynebacteria are uncommon but increasingly recognized as agents of endocarditis in patients with underlying structural heart disease or prosthetic-valves. We describe three cases of nosocomial endocarditis caused by nondiphtheriae corynebacteria, including the first reported case of Corynebacterium amycolatum, endocarditis. These all occurred in association with indwelling intravascular devices.

We present a unique case of rapidly fatal native aortic-valve endocarditis due to Corynebacterium jeikeium, with inoculation as a complication of repeated femoral vascular access for coronary angiography.

A case of bacterial endocarditis caused by Corynebacterium group JK treated with penicillin, chloramphenicol and gentamycin has been described. Finally the artificial aortal valve has been implanted.

Background: Corynebacterium is known as a pathogen for man, particularly C. diphtheriae, while other species may cause disease and particularly cardiac valve infection, mainly in immunosuppressed patients, intravenous drug addicts, valve prosthesis carriers, patients with previous valvular disease, with congenital heart diseases or those submitted to cardiothoracic surgery., Methods: Seven episodes of endocarditis due to Corynebacterium no diphtheriae among six patients admitted to our hospital between 1989 and 1992 are analyzed., Results: The mitral valve was often affected with a predominance of incidence in the native valve. Four cases were cured with antibiotic therapy and in three patients surgical valve replacement was required. Recurrence of endocarditis was observed in one of the patients. One case of mycotic cerebral aneurysm and one intracranial hemorrhage are complications of note. One of the patients had undergone kidney transplantation being the first case described with endocarditis by C. no diphtheriae in this subset of patients. Transesophageal echocardiography was the principal diagnostic measure., Conclusions: The increase in the number of immunosuppressed patients (organ transplantations and acquired immunodeficiency syndrome) and prosthesis carriers wake advisable that these microorganisms be taken into account as etiologic agents of infectious endocarditis.

We encountered a case of native valve endocarditis due to Corynebacterium CDC group I1 which was successfully controlled with antimicrobial agents alone. This organism and three other isolates of this group were susceptible to penicillin, vancomycin, and gentamicin. The combination of penicillin with subinhibitory concentrations of gentamicin resulted in a 1,000-fold decrease in CFU per milliliter at 24 h compared with penicillin alone. Augmentation of killing was noted also with vancomycin plus gentamicin but to a degree that did not meet strict criteria for bactericidal synergism.

A patient with endocarditis caused by Corynebacterium CDC Group A-4 is described. This is the first case in the literature of endocarditis caused by this bacteria, and is unique in that the patient was immune competent and the infection occurred on a native valve. This case illustrates that corynebacteria cannot be considered a contaminant and that the exact pathogen should be identified.

A case of prosthetic valve endocarditis caused by Corynebacterium pilosum in a 79-year-old woman developed eighty years after aortic valve replacement with bovine pericardium bioprosthesis is described. In spite of the antibiotic therapy she presented an unfavourable course that led to her death.

Endocarditis caused by a Corynebacterium sp. resistant to vancomycin, penicillin G, erythromycin, gentamicin and rifampicin arose in a 44-year-old woman 4 months after replacement of the mitral valve with a prosthesis. She was successfully treated with a 79-day course of intravenous imipenem and ciprofloxacin and replacement of the prosthesis 48 days after treatment began.

Here we report a case of Corynebacterium G1 group endocarditis following acute bpn in non immunodeficient host. The bacterial strain was isolated from the surgically removed heart valve. To our knowledge this is the first report of such an isolate. Recently recurrent peritonitis in CAPD were also ascribed to the same agent.

Clinical features, microbiology, therapy and outcome of 26 episodes of prosthetic valve endocarditis occurring at Westmead Hospital from 1979 to 1989 were examined retrospectively. Presentation with a new or changed cardiac murmur was associated with early onset infection (within 12 months of prosthetic valve insertion; P = 0.0033). Corynebacteria were the commonest cause of early onset endocarditis (4 of 11 episodes) and Streptococcus viridans of late onset endocarditis (4 of 15 episodes). Nine of 11 episodes responded to antimicrobial therapy and 12 of 15 to medical-surgical therapy. There was a trend towards increased mortality in patients with early onset endocarditis presenting with a new or changed cardiac murmur (4 of 9 v. 1 of 17, P = 0.068), suggesting early surgery should be considered in this group. Analysis of antibiograms and published reports indicated that vancomycin and an aminoglycoside should be recommended as empirical therapy for endocarditis occurring 12 to 18 months after prosthetic valve insertion.

The authors report a case of Corynebacterium (group JK) endocarditis. The main characteristics of the causative pathogen are specified: diagnostic bacteriological criteria, pathogenic capability after cardiac surgery, therapeutic problems related to resistance to antibiotics.

Thirty-one cases of bacterial endocarditis in adult dairy cows were reviewed. Clinical signs were reflective of the stage of the disease. Recurrent or persistent fever, tachycardia and a pounding heartbeat or systolic murmur, polypnea, and lameness were typical. With chronicity, weight loss and poor production developed. The end stage was congestive heart failure. Neutrophilia was typical in early cases. Low-grade anemia and high total serum globulin content developed with chronicity and seemed to be negative prognostic signs. Corynebacterium pyogenes was the organism most frequently identified by blood culture or at necropsy. Twenty cows were necropsied and 2 cows were sent to slaughter. Nine cows in which the diagnosis was made early in the course of the disease responded to long-term penicillin therapy.

Three patients who had coryneform bacterial endocarditis affecting a prosthetic valve are presented and 64 case reports are reviewed. Diagnostic difficulties occur because coryneform bacteria often are fastidiuos, with long incubation periods, and often contaminate blood cultures. Although some coryneform bacteria are killed by penicillin G, many are resistant to most of the commonly used antibiotics. Vancomycin is bactericidal in resistant strains studied. Treatment with vancomycin is indicated until in vitro bactericidal data are available. Coryneform endocarditis often occurs on prosthetic valves, thus making therapy and its evaluation even more difficult.

Fifteen patients with bacterial endocarditis were treated with vancomycin between 1967 and 1976. The indications for vancomycin therapy were penicillin-cephalosporin allergy in six patients, antibiotic resistant bacteria in six, initial therapy in one and culture-negative endocarditis in two. The causative microorganisms were Staph. epidermidis (four patients), Staph. aureus (two patients), diphtheroids (four patients), viridans streptococci (two patients) and enterococci (one patient). Minimum inhibitory concentrations of vancomycin for these organisms ranged from 0.8 to 3.1 micrograms/ml. The patients received vancomycin for two to 10 weeks (mean five weeks). Cure was achieved in 13 patients, including six with prosthetic valve endocarditis (PVE). Two patients had a relapse of PVE and cultures of blood or heart valve were positive within two months of vancomycin therapy. Vancomycin serum levels did not exceed 50 micrograms/ml, and no serious drug toxicity was encountered in any patient. Three patients had minimal audiogram changes beyond the social hearing range. One patient had mild phlebitis and a rash, and one patient had a transient leukopenia. Vancomycin is an effective nontoxic antibiotic in patients with endocarditis when penicillin or cephalosporin therapy is not appropriate.