An autopsy case of ventilator-associated tracheobronchitis caused by Corynebacterium species complicated with diffuse alveolar damage

Abstract

Ventilator-associated tracheobronchitis (VAT) has been reported to occur in 11% of intubated patients. Corynebacterium spp. can cause lower respiratory infections; however, to our knowledge, there have been no reported cases of VAT caused by Corynebacterium spp. A 55-year-old man was hospitalized with acute respiratory failure after autologous peripheral blood stem cell transplantation for Hodgkin lymphoma. Chest computed tomography showed diffuse ground-glass opacities in both lung fields. A few days after tracheal intubation, steroid pulse, and antibacterial drugs, the patient's pulmonary involvement temporarily improved. However, these opacities rapidly deteriorated, leading to death about 2 weeks after hospitalization. No significant bacteria other than Corynebacterium spp. were detected in sputum cultures during treatment and in blood culture at autopsy. Histological findings revealed tracheitis and diffuse alveolar damage. According to these findings, we diagnosed the patient as having VAT caused by Corynebacterium spp. This report suggests that Corynebacterium spp. might be an important causative pathogen of VAT in immunodeficient patients who undergo tracheal intubation. Additionally, optimal treatment for Corynebacterium spp. must be determined.

Keywords

• Corynebacterium spp
• Diffuse alveolar damage
• Ventilator-associated tracheitis
• Ventilator-associated pneumonia