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Corynebacterium jeikeium native valve infective endocarditis case report: a confirmed microbiological and

Wentzel Bruce Dowling1, Johan Koen2

  • 1Division of Medical Microbiology and Immunology, Department of Pathology, University of Stellenbosch, National Health Laboratory Service, Tygerberg Hospital, 1 Francie van Zijl Drive, Cape Town 7500, South Africa.

European Heart Journal. Case Reports
|January 15, 2021
PubMed

Insights

This case study details a rare instance of infective endocarditis (IE) caused by antibiotic-resistant Corynebacterium jeikeium. Diagnosis was confirmed via heart valve tissue culture, emphasizing the Modified Duke criteria for left-sided IE.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Infective endocarditis (IE) diagnosis relies on the Modified Duke criteria.
  • Corynebacterium jeikeium is an uncommon IE pathogen, frequently exhibiting antimicrobial resistance.
  • This report details a case of C. jeikeium IE that met the Modified Duke pathological criteria.

Purpose of the Study:

  • To present a unique case of infective endocarditis caused by Corynebacterium jeikeium.
  • To underscore the diagnostic significance of the Modified Duke criteria in challenging IE cases.
  • To highlight the management of a rare mixed-infection IE scenario.

Main Methods:

  • A patient with peripheral vascular disease underwent amputation.
  • Echocardiography revealed severe aortic valve regurgitation with vegetations, necessitating valve replacement.
  • Blood cultures initially identified Streptococcus mitis, while aortic valve tissue later cultured Corynebacterium jeikeium.

Main Results:

  • The patient presented with septic changes secondary to peripheral vascular disease.
  • Severe aortic valve regurgitation and vegetations were identified, leading to valve replacement.
  • Corynebacterium jeikeium was isolated from the explanted aortic valve, confirming IE with characteristic histological changes.

Conclusions:

  • This is the first reported case of Corynebacterium jeikeium IE diagnosed through heart valvular tissue culture.
  • The case emphasizes the critical role of the Modified Duke criteria in diagnosing left-sided IE.
  • The findings suggest a possible instance of masked resistant C. jeikeium IE following initial treatment for Streptococcus mitis.
Abstract

Keywords:
Case reportCorynebacterium jeikeiumInfective endocarditisModified Duke

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