Native valve endocarditis caused by Corynebacterium striatum without underlying structural heart disease or indwelling cardiovascular medical devices: a case report

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 939 - 8
• Main Authors: Usuda, Daisuke, Kojima, Yuhei, Ono, Rikuo, Kaneoka, Yuki, Kato, Masashi, Sugawara, Yuto, Shimizu, Runa, Inami, Tomotari, Nakajima, Eri, Tsuge, Shiho, Sakurai, Riki, Kawai, Kenji, Matsubara, Shun, Tanaka, Risa, Suzuki, Makoto, Shimozawa, Shintaro, Hotchi, Yuta, Osugi, Ippei, Katou, Risa, Ito, Sakurako, Mishima, Kentaro, Kondo, Akihiko, Mizuno, Keiko, Takami, Hiroki, Komatsu, Takayuki, Nomura, Tomohisa, Sugita, Manabu
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 09.09.2024; BioMed Central; BMC
• Subjects: Actinomycetales infections; Adult; Ampicillin; Angiography; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteremia; Bacterial pneumonia; Biochemistry; Blood pressure; Blood tests; Body temperature; Cardiovascular disease; Cardiovascular diseases; Cardiovascular system; Care and treatment; Case Report; Case studies; Causes of; Cerebellum; Complications and side effects; Computed tomography; Corynebacterium - isolation & purification; Corynebacterium Infections - drug therapy; Corynebacterium Infections - microbiology; Corynebacterium striatum; CT imaging; Decompression; Development and progression; Diagnostic imaging; Dissection; Echocardiography; Electrocardiography; Endocarditis; Endocarditis, Bacterial - drug therapy; Endocarditis, Bacterial - microbiology; Erythema; Etiology; Female; Fever; Flora; Glasgow Coma Scale; Health aspects; Heart diseases; Heart rate; Hospitals; Humans; Hydrocephalus; Hyperthermia; Illnesses; Immunocompetence; Infarction; Infections; Infective endocarditis; Levofloxacin; Medical devices; Medical equipment; Medical imaging; Mitral valve; Mitral Valve - microbiology; Mitral Valve - surgery; Native valve endocarditis; Nosocomial infection; Oxygen saturation; Pathogens; Patients; Penicillin G; Physiological apparatus; Pneumonia; Rare diseases; Rheumatic heart disease; Skin diseases; Stroke; Sulbactam; Therapeutic drug monitoring; Tomography; Treatment; Urinalysis; Vancomycin; Vegetation; Veins & arteries; Vertebrae; Young adults; Japan; Case report; Treatment; Etiology; Corynebacterium striatum; Bacteremia; Native valve endocarditis
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09825-9

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. 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. We report the rare case of C. striatum mitral valve NVE in a young adult without structural heart disease or indwelling cardiovascular devices. Not applicable.