Corynebacterium DiphtheriaeEndocarditis - Surgery for Some but Not All!

Abstract

Corynebacterium diphtheriae endocarditis was thought to be a rare disease. We reviewed our experience in four cases of this disease treated over a period of 10 years. Seventy cases reported in literature were reviewed. The outcome is good if cases are carefully selected for medical or surgical treatment. We conclude that infective endocarditis due to C. diphtheriae, is perhaps more common than expected. It may be recognized more frequently and on occasion may be an aggressive disease. Those patients with an abnormal valve (including prosthetic valves) should be subjected to surgery at the earliest available opportunity, whereas patients with normal valves may be carefully watched during the course of medical treatment as long as immediate surgery can occur if needed.

Usefulness of 16S rDNA sequencing for the diagnosis of infective endocarditis caused by Corynebacterium diphtheriae

“…There has been a resurgence of infections caused by C. diphtheriae in many parts of the world and nontoxigenic strains have been increasingly reported as a cause of invasive disease, including endocarditis, in the recent past (Menon et al, 2010;Mishra et al, 2005;Reacher et al, 2000;Holthouse et al, 1998).…”

Multilocus sequence types of invasive Corynebacterium diphtheriae isolated in the Rio de Janeiro urban area, Brazil

“…Most of the reports in the literature regarding invasive infections caused by C. diphtheriae are related to infective endocarditis [5]. Mortality rates are estimated to be high (43 % in the cases reviewed by Mishra et al [5]), and predisposing factors such as incompetent cardiac valves and intravenous drug use apparently contribute to most cases [5].…”

Nontoxigenic Corynebacterium diphtheriae: A Rare Cause of Infective Endocarditis in Native Valve

“…diphtheriae endocarditis has been described as an aggressive and destructive disease, similar to Staphylococcus aureus endocarditis, with a high rate of complications [1].…”

“…It was first described in 1884 by Loeffler as the causative agent of diphtheria and the first case of infective endocarditis caused by this organism was reported in 1893 [1][2]. Toxin production may cause disseminated illness with pharyngeal membrane production, myocarditis and neurological and renal dysfunction [3].…”