Corynebacterium striatum Infective Endocarditis from Different Perspectives: A Comprehensive Literature Review

Corynebacterium striatum infective endocarditis (IE) is rare but increasingly recognized. Delays in the diagnosis and treatment of subacute IE caused by C. striatum are possible. In patients with predisposing risk factors, it is essential to carefully review clinical history and imaging findings before dismissing C. striatum isolated from repeated blood cultures as a contaminant. This study aimed to present two cases of C. striatum IE and to review all published cases in the literature.

Case reports describing C. striatum IE were identified through PubMed, Scopus, and ULAKBIM databases up to August 1, 2024. Studies providing data on the epidemiology, clinical characteristics, microbiology, treatment, and outcomes were included. Eligible cases from the literature, along with the two cases presented herein, were analyzed collectively.

A total of 53 patients were included in the study. The median (range) age was 63 (24-91) years, with a male predominance (62.3%). Previous C. striatum bacteremia during earlier hospitalizations was reported in 18.9% of cases. The most frequent predisposing factors were hemodialysis (20.8%), prosthetic valves (18.9%), and cardiac implantable electronic devices (13.2%). Native valve involvement was present in 67.9% of cases, most commonly affecting the mitral and aortic valves. The in-hospital mortality rate was 24.5%.

The predominance of native valve involvement and the high prevalence of hemodialysis among patients with C. striatum IE suggest that vascular access-related bacteremia may play a key role in disease pathogenesis. Effective management requires prolonged, targeted antimicrobial therapy, often in combination with surgical intervention.