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Corynebacterium Striatum Septicemia Due to Indwelling Pleural Catheter
Description
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A5221 - Corynebacterium Striatum Septicemia Due to Indwelling Pleural Catheter
Author Block: S. Hossain1, W. Khan2; 1Internal Medicine, Rutgers Robert Wood Johnson, New Brunswick, NJ, United States, 2Pulmonary and Critical Care, University Medical Center of Princeton at Plainsboro, Plainsboro, NJ, United States.
Introduction:
Corynebacterium striatum (C. Striatum) is a diphtherioid strain of Corynebacterium that is increasingly being recognized as an emerging pathogen. Isolated case reports of C. Striatum causing infections such as infective endocarditis, and intravenous catheter infections have been described.1 We describe a rare case of C. striatum causing sepsis secondary to an indwelling pleural catheter infection.
Case:
A 31-year-old female with metastatic breast cancer and known metastatic pleural effusions presented for worsening dyspnea. The pleural effusions had previously been drained on multiple occasions. Imaging once again revealed recurrent pleural effusions. Thus, bilateral indwelling pleural catheters were placed. The patient's respiratory status improved and she was discharged home. However, within two weeks of catheter placement, the patient was readmitted to the hospital for septicemia. Pleural catheter tip, pleural fluid, and 2 sets of blood cultures were positive for gram positive rods, later identified as C. Striatum. The pathogen was susceptible to Vancomycin and Meropenem. The catheters were removed and the patient completed a 14-day course of antibiotics. She was able to overcome the infection and was discharged home. Unfortunately, the patient later succumbed to complications of her malignancy burden, and died of non-infectious causes within a few months.
Discussion:
C. Striatum is not a common pathogen, but has been an emerging cause of infection. While prior cases have described infection in the setting of indwelling catheters, we describe the first case to our knowledge, of inoculation and successful seeding of the bacterium via indwelling pleural catheter. Overall, indwelling pleural catheters have a low infection rate of approximately 4.8%.2 Common organisms causing indwelling pleural catheters infections typically include Staphylococcus or Pseudomonas species.
1. Daisuke, Ueno et al. “ Corynebacterium Striatum Bacteremia Associated with a Catheter-Related Blood Stream Infection.” Case Reports in Infectious Diseases 2017 (2017): 2682149. PMC. Web. 1 Nov. 2017.
2. Lui MMS, Thomas R, Lee YCG. Complications of indwelling pleural catheter use and their management. BMJ Open Respiratory Research. 2016;3(1):e000123. doi:10.1136/bmjresp-2015-000123.
Author Block: S. Hossain1, W. Khan2; 1Internal Medicine, Rutgers Robert Wood Johnson, New Brunswick, NJ, United States, 2Pulmonary and Critical Care, University Medical Center of Princeton at Plainsboro, Plainsboro, NJ, United States.
Introduction:
Corynebacterium striatum (C. Striatum) is a diphtherioid strain of Corynebacterium that is increasingly being recognized as an emerging pathogen. Isolated case reports of C. Striatum causing infections such as infective endocarditis, and intravenous catheter infections have been described.1 We describe a rare case of C. striatum causing sepsis secondary to an indwelling pleural catheter infection.
Case:
A 31-year-old female with metastatic breast cancer and known metastatic pleural effusions presented for worsening dyspnea. The pleural effusions had previously been drained on multiple occasions. Imaging once again revealed recurrent pleural effusions. Thus, bilateral indwelling pleural catheters were placed. The patient's respiratory status improved and she was discharged home. However, within two weeks of catheter placement, the patient was readmitted to the hospital for septicemia. Pleural catheter tip, pleural fluid, and 2 sets of blood cultures were positive for gram positive rods, later identified as C. Striatum. The pathogen was susceptible to Vancomycin and Meropenem. The catheters were removed and the patient completed a 14-day course of antibiotics. She was able to overcome the infection and was discharged home. Unfortunately, the patient later succumbed to complications of her malignancy burden, and died of non-infectious causes within a few months.
Discussion:
C. Striatum is not a common pathogen, but has been an emerging cause of infection. While prior cases have described infection in the setting of indwelling catheters, we describe the first case to our knowledge, of inoculation and successful seeding of the bacterium via indwelling pleural catheter. Overall, indwelling pleural catheters have a low infection rate of approximately 4.8%.2 Common organisms causing indwelling pleural catheters infections typically include Staphylococcus or Pseudomonas species.
1. Daisuke, Ueno et al. “ Corynebacterium Striatum Bacteremia Associated with a Catheter-Related Blood Stream Infection.” Case Reports in Infectious Diseases 2017 (2017): 2682149. PMC. Web. 1 Nov. 2017.
2. Lui MMS, Thomas R, Lee YCG. Complications of indwelling pleural catheter use and their management. BMJ Open Respiratory Research. 2016;3(1):e000123. doi:10.1136/bmjresp-2015-000123.
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