J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 12, Number 2, February 2021, pages 61-64

Corynebacterium striatum Cardiac Device-Related Infective Endocarditis: The First Case Report in a Patient With a Cardiac Resynchronization Therapy Defibrillator Device and Review of the Literature

Figure 1. Transesophageal echocardiogram showing the vegetation adherent to the posterior leaflet of tricuspid valve. This exam was unremarkable for fibrin-sheath, masses or vegetations adherent to the electrocatheter.

Figure 2. Parasternal short-axis mitral valve unconventional view displaying de novo fibrin-sheath involving the electrocatheter with an additional punctiform image.

**Table 1.** Literature Review of Case Reports of *Corynebacterium striatum* Cardiac Device-Related Infective Endocarditis
Ref.	Gender, age	Comorbidities	Cardiac devices	IE location (and other infected locations associated)	TTE and TTE findings	Cultures positive to C. striatum	Antibiotic susceptibility testing reveling sensitivity (MIC, in µg/mL)	Medical treatment	Surgery	Outcome
BC: blood cultures; D: in-patient day; F: female; IE: infective endocarditis; M: male; MIC: minimum inhibitory concentration; ND: not described; Ref.: reference; TEE: transesophageal echocardiography; TTE: transthoracic echocardiography.
[3]	M, 73	ND	Pacemaker (6 years before, with battery replacement 2 years before without removal of old electrode wire)	Intracardiac lead and tricuspid valve (pacemaker sinus tract)	TTE: normal; TEE: vegetations on the old electrode wire	BC; drainage pus	Vancomycin (ND)	1) Vancomycin (4 weeks); 2) Co-trimoxazole + rifampin (4 weeks); 3) Vancomycin (4 weeks)	Yes (1st intervention: removal of pacemaker battery; 2nd intervention: removal of old electrode wire)	Alive
[4]	F, 71	ND	Pacemaker (replaced 2 months before)	Intracardiac lead (ND)	TTE: mobile mass adherent to the intracardiac lead	Device	Vancomycin (0.5)/linezolid (0.25)/daptomycin (0.125)	1) Daptomycin 6mg/kg body weight (7 days); 2) Linezolid; 3) Daptomycin (4 weeks)	Yes (8th day, device removal, and reimplantation of a new pacemaker)	Alive
[5]	M, 51	ND	Pacemaker (7 months before)	Pacemaker intraatrial lead (ND)	TEE: vegetations intracardiac wire	BC; device	Penicillin (ND)/gentamicin (ND)/tobramycin (ND)/erythromycin (ND)/lincomycin (ND)/linezolid (ND)/chloramphenicol (ND)/tetracycline (ND)/rifampicin (ND)/co-trimoxazole (ND)/ofloxacin (ND)/teicoplanin (ND)/vancomycin (ND)	1) Vancomycin + ciprofloxacin (6 weeks)	Yes (device removal)	Alive
[6]	M, 78	Diabetes, chronic renal failure	Pacemaker (6 months before)	Pacemaker intraventricular lead and tricuspid valve (spondylodiscitis D10 - D11 and epidural abscess)	TTE: mobile masses adherent to the intracardiac lead from the tricuspid valve to the right ventricular wall.	BC	Daptomycin (0.064)/vancomycin (0.36)	1) Daptomycin 10 mg/kg	Yes (10th day removal of electrode wires followed by re-implantation of new wires 9 days later)	Alive
[7]	F, 79	ND	Pacemaker (7 years before)	Pacemaker lead (ND)	TTE: normal; TEE: normal	BC; device	ND	1) Vancomycin (6 weeks)	Yes (pacemaker removal due to dysfunction)	Alive

Table 1. Literature Review of Case Reports of Corynebacterium striatum Cardiac Device-Related Infective Endocarditis

Ref.

Gender, age

Comorbidities

Cardiac devices

IE location (and other infected locations associated)

TTE and TTE findings

Cultures positive to C. striatum

Antibiotic susceptibility testing reveling sensitivity (MIC, in µg/mL)

Medical treatment

Surgery

Outcome

BC: blood cultures; D: in-patient day; F: female; IE: infective endocarditis; M: male; MIC: minimum inhibitory concentration; ND: not described; Ref.: reference; TEE: transesophageal echocardiography; TTE: transthoracic echocardiography.

[3]

M, 73

Pacemaker (6 years before, with battery replacement 2 years before without removal of old electrode wire)

Intracardiac lead and tricuspid valve (pacemaker sinus tract)

TTE: normal; TEE: vegetations on the old electrode wire

BC; drainage pus

Vancomycin (ND)

1) Vancomycin (4 weeks); 2) Co-trimoxazole + rifampin (4 weeks); 3) Vancomycin (4 weeks)

Yes (1st intervention: removal of pacemaker battery; 2nd intervention: removal of old electrode wire)

Alive

[4]

F, 71

Pacemaker (replaced 2 months before)

Intracardiac lead (ND)

TTE: mobile mass adherent to the intracardiac lead

Device

Vancomycin (0.5)/linezolid (0.25)/daptomycin (0.125)

1) Daptomycin 6mg/kg body weight (7 days); 2) Linezolid; 3) Daptomycin (4 weeks)

Yes (8th day, device removal, and reimplantation of a new pacemaker)

Alive

[5]

M, 51

Pacemaker (7 months before)

Pacemaker intraatrial lead (ND)

TEE: vegetations intracardiac wire

BC; device

Penicillin (ND)/gentamicin (ND)/tobramycin (ND)/erythromycin (ND)/lincomycin (ND)/linezolid (ND)/chloramphenicol (ND)/tetracycline (ND)/rifampicin (ND)/co-trimoxazole (ND)/ofloxacin (ND)/teicoplanin (ND)/vancomycin (ND)

1) Vancomycin + ciprofloxacin (6 weeks)

Yes (device removal)

Alive

[6]

M, 78

Diabetes, chronic renal failure

Pacemaker (6 months before)

Pacemaker intraventricular lead and tricuspid valve (spondylodiscitis D10 - D11 and epidural abscess)

TTE: mobile masses adherent to the intracardiac lead from the tricuspid valve to the right ventricular wall.

Daptomycin (0.064)/vancomycin (0.36)

1) Daptomycin 10 mg/kg

Yes (10th day removal of electrode wires followed by re-implantation of new wires 9 days later)

Alive

[7]

F, 79

Pacemaker (7 years before)

Pacemaker lead (ND)

TTE: normal; TEE: normal

BC; device

1) Vancomycin (6 weeks)

Yes (pacemaker removal due to dysfunction)

Alive