Even a single positive blood culture may matter – A case of prosthetic valve infective endocarditis caused by Corynebacterium kroppenstedtii
Adam Cewers,
Torgny Sunnerhagen,
Patrik Gilje,
Fredrik Wannheden,
Jonas Bläckberg,
Per Wierup,
Mårten Larsson,
Magnus Rasmussen
Affiliations
Adam Cewers
Division of Infection Medicine, Helsingborg Hospital, Helsingborg, Sweden; Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
Torgny Sunnerhagen
Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Clinical Microbiology, Infection Control and Prevention, Office for Medical Services, Region Skåne, Lund, Sweden; Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
Patrik Gilje
Department of Cardiology, Clinical Sciences, Lund University and Skane University Hospital, SE-221 85 Lund, Sweden
Fredrik Wannheden
Department of Clinical Physiology, Clinical Sciences, Lund University, SE-221 85 Lund, Sweden
Jonas Bläckberg
Division of Infection Medicine, Helsingborg Hospital, Helsingborg, Sweden; Department of Clinical Microbiology, Infection Control and Prevention, Office for Medical Services, Region Skåne, Lund, Sweden; Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden
Per Wierup
Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Lund, Sweden
Mårten Larsson
Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Lund, Sweden
Magnus Rasmussen
Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden; Correspondence to: Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, BMC B14, SE-223 63 Lund, Sweden.
Corynebacterium is a skin commensal bacterium that can contaminate blood cultures. It is however also a rare cause of infective endocarditis (IE). Here we report a case of Corynebacterium kroppenstedtii aortic prosthesis IE in a 76-year-old man where only a single blood culture bottle was positive initially. C. kroppenstedtii is a very rare cause of IE, only reported two times previously. The diagnosis in our case was confirmed by repeated blood culture positivity and eventually by detection of DNA from C. kroppenstedtii on heart valves after valve exchange surgery. At surgery an aortic root abscess was detected and the valve was replaced by a homograft. Recovery was complicated by antibiotic-induced nephrotoxicity and treatment was concluded with moxifloxacin in combination with rifampicin. Recovery was uneventful. This case demonstrates that growth in even a single blood culture bottle may be important in patients with prosthetic heart valves.
