Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. Feb 25, 2014; 4(1): 1-4
Published online Feb 25, 2014. doi: 10.5495/wjcid.v4.i1.1
Sub-acute endocarditis by Corynebacterium straitum: An often ignored pathogen
Vratika Agarwal, Valay Parikh, Mayur Lakhani, Chitradeep De, Apurva Motivala, Neville Mobarakai
Vratika Agarwal, Internal Medicine Department, Staten Island University Hospital, Staten Island, NY 10305, United States
Valay Parikh, Mayur Lakhani, Chitradeep De, Apurva Motivala, Department of Cardiology, Staten Island University Hospital, Staten Island, NY 10305, United States
Neville Mobarakai, Department of Infectious Disease, Staten Island University Hospital, Staten Island, NY 10305, United States
Author contributions: Agarwal V and Parikh V contributed to drafting of the manuscript; Lakhani M and De C contributed to overseeing the manuscript and image selection; Motivala A and Mobarakai N contributed to critical revision and approval.
Correspondence to: Valay Parikh, MBBS, Internal Medicine Department, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, United States. valayparikh@gmail.com
Telephone: +1-630-4798473 Fax: +1-718-2269506
Received: December 11, 2013
Revised: December 21, 2013
Accepted: February 3, 2014
Published online: February 25, 2014
Processing time: 160 Days and 2 Hours
Abstract

With the emergence of novel etiologic organisms, pan-resistance, and invasive medical care infective endocarditis continues to be evasive, requiring newer approaches and modified treatment guidelines. Presented here is the case of a 75-year-old male with history of systolic heart failure with an automatic internal cardioverter defibrillator (AICD) implantation and a prosthetic mitral valve who presented with generalized malaise and progressive shortness of breath for 6 d. He was found to have positive blood cultures for gram positive rod shaped bacteria identified as Corynebacterium straitum, but was not considered as the etiological pathogen initially as it a usual skin contaminant. Later this bacterium was found to be the causative agent for the patient’s endocarditis. This case highlights the importance of identifying the role of this uncommon commensal in invasive disease. With the use of effective antibiotic regimen and awareness of these new pathogens in invasive disease, mortality and morbidity can be prevented with initiation of early appropriate therapy.

Keywords: Corynebacterium straitum; Endocarditis; Commensals; Catheter associated infections; Iatrogenic

Core tip: This report highlights the pathogenicity of previously considered commensals like Corynebacterium striatum in severe human disease. Clinicians and microbiologists should not overlook the potential virulence of commensals in appropriate clinical situations. Furthermore, our case highlights an important point regarding the emergence of new pathogens in the etiology of infective endocarditis and also throws light on the increased incidence of endocarditis with the use of indwelling catheters and aggressive invasive medical management. As this issue is of growing concern with respect to infections that are easily avoidable.