A case series of Corynebacterium striatum native valve infective endocarditis

Corynebacterium species isolated in blood cultures are commonly dismissed as a contaminant. They are also recognized as an uncommon pathogen in infective endocarditis. We report two cases of native valve endocarditis due to Corynebacterium striatum. The first patient, a 36-year-old female with hemolytic anemia, whose risk factor for endocarditis was a Port-a-Cath (Smiths Medical, Los Angeles, California) used for routine blood transfusions. She was diagnosed with triple valve endocarditis via transthoracic echocardiogram. Her multiple comorbidities made her a poor surgical candidate for valve replacement and she elected to go on hospice care after antibiotic treatment completion. The second patient, a 46-year-old, was found to have coronavirus disease 2019 (COVID-19) pneumonia in addition to persistent Corynebacterium striatum bacteremia. A transthoracic echocardiogram was highly suggestive of aortic valve endocarditis. A confirmatory transesophageal echocardiogram was unable to be obtained given his clinical instability and COVID-19 status. Unfortunately, this patient expired due to complications of severe COVID-19 pneumonia. We highlight the need for prompt recognition of risk factors of infective endocarditis due to uncommon pathogens that may aid in the diagnosis and treatment, while utilizing a multidisciplinary approach.

Learning objective: The aim of this case series is to emphasize the importance of Corynebacterium species as a cause of native valve infectious endocarditis and to illustrate the challenges it poses in diagnosis and management.