Document Detail

Corynebacterium diphtheriae endocarditis: a case series and review of the treatment approach.
MedLine Citation:
PMID:  21641260     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Infective endocarditis due to non-toxigenic Corynebacterium diphtheriae is uncommon; we report 10 cases occurring over a 14-year period in Auckland, New Zealand and review the approach for treatment.
CASE SERIES: Eight of the 10 patients had known prosthetic valves or homografts in situ. Three patients required surgical intervention for infective endocarditis. Seven patients were treated with a combination of β-lactam and aminoglycoside, and one each was treated with a combination of vancomycin and an aminoglycoside, a β-lactam alone, and vancomycin alone. All patients survived and none relapsed.
REVIEW OF LITERATURE: The antibiotic treatment of 46 previously reported cases was reviewed; patients treated with a β-lactam and aminoglycoside (n=25), and without the addition of an aminoglycoside (n=11) were compared. The differences in length of treatment within each group make the comparison of outcome (mortality, need for surgical intervention, disease and treatment complications) difficult. However, regardless of the length of treatment, there was no difference in mortality or need for surgical intervention between the two groups in the currently published cases.
CONCLUSIONS: Current evidence suggests that endocarditis of either native or prosthetic valves, caused by penicillin-susceptible C. diphtheriae, demonstrates a favorable outcome when treated with either a β-lactam alone or in combination with an aminoglycoside. Patient-specific factors will determine which approach is more appropriate for each individual patient.
S Muttaiyah; E J Best; J T Freeman; S L Taylor; A J Morris; S A Roberts
Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2011-06-08
Journal Detail:
Title:  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases     Volume:  15     ISSN:  1878-3511     ISO Abbreviation:  Int. J. Infect. Dis.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-25     Completed Date:  2011-12-20     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e584-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Department of Microbiology, Auckland City Hospital, Private Bag 92026, Grafton, Auckland, New Zealand.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Child, Preschool
Corynebacterium diphtheriae*
Diphtheria / drug therapy,  microbiology,  therapy*
Endocarditis, Bacterial / drug therapy,  microbiology,  therapy*
Middle Aged
New Zealand
Risk Factors
Treatment Outcome
Young Adult
Reg. No./Substance:
0/Anti-Bacterial Agents

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