Trepeta R W, Edberg S C
Am J Clin Pathol. 1984 May;81(5):679-83. doi: 10.1093/ajcp/81.5.679.
This communication concerns a case of endocarditis caused by Corynebacterium diphtheriae. The patient was a 35-year-old male drug addict who was brought to the hospital with fever, chills, and abdominal pain. Two days after admission, blood cultures were found to be growing gram-positive rods suggestive of diphtheroids. Repeated blood cultures grew the same organism, which was identified as a nontoxigenic strain of C. diphtheriae. The patient subsequently was identified as having acquired immune deficiency syndrome. Although isolates are divided into toxigenic and nontoxigenic strains, all isolates of C. diphtheriae should be considered potentially toxigenic. Because diphtheria generally is considered only of historic interest, few laboratories perform tests to identify it and instead report all isolates as "diphtheroids" or Corynebacterium. Because all isolates are potentially toxigenic, and because there is a large reservoir of nonimmunized people, laboratories must be alert to possible serious epidemiologic situations.
本通讯涉及一例由白喉棒状杆菌引起的心内膜炎病例。患者为一名35岁的男性吸毒者，因发热、寒战和腹痛被送往医院。入院两天后，血培养发现生长出革兰氏阳性杆菌，提示类白喉杆菌。重复血培养生长出相同的微生物，鉴定为白喉棒状杆菌的非产毒株。该患者随后被确诊患有获得性免疫缺陷综合征。虽然分离株分为产毒株和非产毒株，但所有白喉棒状杆菌分离株都应被视为潜在产毒株。由于白喉一般仅被认为具有历史意义，很少有实验室进行鉴定它的检测，而是将所有分离株报告为“类白喉杆菌”或棒状杆菌。由于所有分离株都有潜在产毒能力，且存在大量未免疫人群，实验室必须警惕可能出现的严重流行病学情况。
