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Corynebacterium CDC Group G Native and Prosthetic Valve Endocarditis
Adil Sattar1, Siegfried Yu2, Janak Koirala3
1Department of Internal Medicine, University of New Mexico School of Medicine , Albuquerque, NM, USA.
Abstract:
We report the first case of native and recurrent prosthetic valve endocarditis with Corynebacterium CDC group G, a rarely reported cause of infective endocarditis (IE). Previously, there have been only two cases reported for prosthetic valve IE caused by these organisms. A 69-year-old female with a known history of mitral valve regurgitation presented with a 3-day history of high-grade fever, pleuritic chest pain and cough. Echocardiography confirmed findings of mitral valve thickening consistent with endocarditis, which subsequently progressed to become large and mobile vegetations. Both sets of blood cultures taken on admission were positive for Corynebacterium CDC group G. Despite removal of a long-term venous access port, the patient's presumed source of line associated bacteremia, mitral valve replacement, and aggressive antibiotic therapy, the patient had recurrence of vegetations on the prosthetic valve. She underwent replacement of her prosthetic mitral valve in the subsequent 2 weeks, before she progressed to disseminated intravascular coagulation and expired. Although they are typically considered contaminants, corynebacteria, in the appropriate clinical setting, should be recognized, identified, and treated as potentially life-threatening infections, particularly in the case of line-associated bacteremias, and native and prosthetic valve endocarditis.
Insights
This case highlights Corynebacterium CDC group G as a rare cause of infective endocarditis (IE). Prompt identification and treatment are crucial for native and prosthetic valve endocarditis, even with aggressive therapy.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Prosthetic valve endocarditis (PVE) presents unique challenges in diagnosis and treatment.
- Corynebacterium species are infrequently implicated in IE, often considered contaminants.
Observation:
- A 69-year-old female presented with symptoms suggestive of endocarditis.
- Blood cultures revealed Corynebacterium CDC group G, a rare pathogen in IE.
- Echocardiography showed progressive vegetations on the mitral valve.
Findings:
- The patient experienced recurrent vegetations on a prosthetic mitral valve despite treatment.
- Despite valve replacement and antibiotics, the infection led to disseminated intravascular coagulation and expiration.
- This case underscores the pathogenicity of Corynebacterium CDC group G in IE.
Implications:
- Corynebacterium CDC group G should be recognized as a potential cause of severe IE, especially in patients with indwelling devices.
- Early and accurate identification of this pathogen is critical for effective management.
- Clinicians must maintain a high index of suspicion for challenging pathogens in native and prosthetic valve endocarditis.
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