Tiley S M, Kociuba K R, Heron L G, Munro R
Department of Microbiology, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia.
Clin Infect Dis. 1993 Feb;16(2):271-5. doi: 10.1093/clind/16.2.271.
We report seven cases of endocarditis due to nontoxigenic Corynebacterium diphtheriae that occurred between October 1990 and September 1991. The patients all lived in the state of New South Wales, Australia. Three patients had preexisting cardiac abnormalities, and one patient used intravenous drugs regularly. The other three patients had no known risk factors for endocarditis. Notable clinical features were the aggressive nature of the infection, the occurrence of septic arthritis in four patients, and major vascular complications in four patients, one of whom died. One patient required urgent mitral valve replacement. All of the isolates were identified as non-toxigenic C. diphtheriae var gravis. Sporadic cases of endocarditis due to C. diphtheriae have rarely been reported; septic arthritis complicating endocarditis due to this organism has not previously been described. This report highlights the importance of identifying Corynebacterium isolates from normally sterile sites at the species level.
我们报告了1990年10月至1991年9月期间发生的7例由无毒力白喉棒状杆菌引起的心内膜炎病例。这些患者均居住在澳大利亚新南威尔士州。3例患者有既往心脏异常，1例患者经常使用静脉注射药物。其他3例患者无已知的心内膜炎危险因素。显著的临床特征包括感染的侵袭性、4例患者发生化脓性关节炎以及4例患者出现主要血管并发症，其中1例死亡。1例患者需要紧急进行二尖瓣置换术。所有分离株均被鉴定为无毒力白喉棒状杆菌重链变种。白喉棒状杆菌引起的心内膜炎散发病例鲜有报道；此前尚未描述过该菌引起的心内膜炎并发化脓性关节炎。本报告强调了在物种水平上从通常无菌部位鉴定棒状杆菌分离株的重要性。
