SHM Converge Scientific Abstract ePoster Gallery-Corynebacterium Jeikeium Endocarditis in an Immunocompetent Patient

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This case report describes a rare instance of <strong>Corynebacterium jeikeium endocarditis in an immunocompetent patient</strong>. <em>C. jeikeium</em> is a gram-positive bacillus commonly found on the skin and is more often associated with infection in immunocompromised patients, especially after exposure related to indwelling lines, coronary procedures, or cardiac surgery. It typically causes <strong>left-sided valvular endocarditis</strong> and may require <strong>valve replacement</strong> more often than endocarditis caused by other Corynebacterium species.

The patient was an <strong>80-year-old man</strong> with hypertension, hyperlipidemia, coronary artery disease status post CABG, and chronic diastolic heart failure. He presented with <strong>weakness, abdominal pain, and fever</strong> after a recent fall that left him largely bedbound with a stage 1 pressure ulcer. CT imaging suggested possible colitis, and he was started on piperacillin-tazobactam. He then developed an <strong>acute multifocal stroke</strong>, and transesophageal echocardiography revealed <strong>mitral valve vegetations</strong> with <strong>severe mitral regurgitation and flail chordae</strong>, consistent with a cardioembolic source.

Blood cultures grew <strong>Corynebacterium jeikeium</strong>, prompting a switch to <strong>vancomycin</strong>, the recommended treatment. However, because of his severe valvular disease, worsening respiratory status, and high surgical risk, he was not considered a candidate for surgery. After discussion with family, he was ultimately transitioned to <strong>hospice care</strong>.

The report highlights that although vancomycin is the treatment of choice, alternatives such as daptomycin or linezolid have been used successfully in case reports. Despite therapy, mortality can be as high as <strong>33%</strong>. The authors note that only a handful of immunocompetent patients with <em>C. jeikeium</em> endocarditis have been reported in the literature.

Asset Subtitle

Daniel Hulgan

Meta Tag

Author List Daniel Hulgan, Grant Potter, Subhan Tabba, Tapan Patel

Category Clinical Vignettes

Concept Corynebacterium jeikeium

Concept Endocarditis

Concept Bacteremia

Concept Blood Culture

Concept Transesophageal Echocardiography

Distinguished Non-Finalist

Presenter Organization Texas Health Presbyterian Dallas

Presenting Author Daniel Hulgan

Track Adult

Keywords

Corynebacterium jeikeium

endocarditis

immunocompetent patient

mitral valve vegetations

severe mitral regurgitation

acute multifocal stroke

vancomycin

blood cultures

valve replacement

hospice care

Corynebacterium jeikeium

Endocarditis

Bacteremia

Blood Culture

Transesophageal Echocardiography