Kocuria kristinae is a catalase-positive, coagulase-negative, Gram-positive coccus found in the environment and in normal skin and mucosa in humans; however, it is rarely isolated from clinical specimens and is considered a nonpathogenic bacterium. We describe a case of catheter-related bacteremia due to K. kristinae in a young adult with propionic acidemia undergoing periodic hemodialysis. The patient had a central venous catheter implanted for total parenteral nutrition approximately 6 months prior to the onset of symptoms because of repeated acute pancreatitis. K. kristinae was isolated from two sets of blood cultures collected from the catheter. Vancomycin followed by cefazolin for 16 days and 5-day ethanol lock therapy successfully eradicated the K. kristinae bacteremia. Although human infections with this organism appear to be rare and are sometimes considered to result from contamination, physicians should not underestimate its significance when it is isolated in clinical specimens.

A 16-year-old boy with Marfan syndrome was scheduled for open-heart surgery for dilated aortic sinuses of Valsalva. Preoperative cardiac catheterization with left ventricular angiography demonstrated bulging at the junction of the mitral annulus with an appearance like 'a swim ring'. Transthoracic echocardiography showed severe mitral prolapse with the mitral valve leaflets rising toward the left atrium and stretching of the chordae tendineae. ECG-gated contrast CT revealed that this bulging was not the left ventricle itself but the interspace between the base of the left ventricle and mitral valve leaflets. This bulging disappeared after mitral valve plasty with an annuloplasty ring. This unusual finding might herald chordae tendinae rupture in Marfan syndrome.