Corynebacteria as a cause of pulmonary infection: a case series and literature review

• Published in: Pneumonia Vol. 10; no. 1; pp. 10 - 8
• Main Authors: Yang, Katharine, Kruse, Robert L., Lin, Weijie V., Musher, Daniel M.
• Format: Journal Article
• Language: English
• Published: England BioMed Central 05.10.2018; BMC
• Subjects: Acquired immune deficiency syndrome; AIDS; Case Report; Corynebacteria; Diphtheroids; HIV; Human immunodeficiency virus; Normal respiratory flora; Pneumonia; Tuberculosis; Viruses; Corynebacteria; Pneumonia; Normal respiratory flora; Diphtheroids
• ISSN: 2200-6133; 2200-6133
• DOI: 10.1186/s41479-018-0054-5

In most cases of community-acquired pneumonia (CAP), an etiologic agent is not determined; the most common report from the microbiological evaluation of sputum cites "normal respiratory flora." Non-diphtheria spp. a component of this flora, is commonly viewed as a contaminant, but it may be the cause of pneumonia and the frequency with which it causes CAP may be underestimated. This report present 3 cases of CAP in which spp. was clearly the predominant isolate; identification was confirmed by matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry. Two cases were caused by and one by Two patients had a tracheostomy and one was on hemodialysis. Patients who received an appropriate antibiotic responded well. When identified as the predominant isolate in sputum from a patient with CAP, spp. should be considered as a potential cause of the infection. In cases with patients who have compromised airway clearance or who are immunocompromised, microaspiration may be responsible. While some spp. are suspectible to antibiotics usually prescribed for CAP, others are susceptible only to vancomycin or aminoglycosides. Vancomycin is thus the appropriate empiric antibiotic, pending speciation and susceptibility test results. The number of reported cases with result of antibiotic susceptibility testing, however, remains limited, and further investigation is needed. Non-diphtheria spp. represent a noteworthy clinical cause of pneumonia. Identification by Gram stain and as a predominant organism on culture demands careful consideration for management.