Recurrent Bacteremia with Corynebacterium Striatum After Prosthetic Valve Replacement: A Case Report

Abstract

Infective endocarditis is typically caused by Staphylococcus aureus (S. aureus), coagulase-negative staphylococci and streptococci but infection with Corynebacterium striatum (C. striatum) is also becoming prominent. We present the case of a 65-year-old female with a recent history of the coronary artery bypass graft with bioprosthetic aortic valve replacement. The surgery was complicated by sternal wound dehiscence with methicillin-sensitive S. aureus (MSSA) for which she was treated for six weeks with intravenous antibiotics. Two months later, she was found to have C. striatum which was treated. A transesophageal echocardiogram was done as well which did not show any vegetation. She presented to the hospital with vomiting, cough, fever, and shortness of breath. She had pyuria on urinalysis and was started on empiric antibiotics after taking blood cultures. She decompensated soon after admission and was transferred to the intensive care unit where she had a pulseless ventricular tachycardia and was resuscitated but required vasopressor support. The blood cultures from admission started growing C. striatum again. Daptomycin was added to the empiric antibiotics and supportive care was continued, but the family decided to make her 'do not resuscitate - comfort care only'. The support was withdrawn and she passed away.