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CEN Case Rep ; 9(3): 220-224, 2020 08.
Article in English | MEDLINE | ID: mdl-32180154

ABSTRACT

Herein, we describe a rare case of Corynebacterium jeikeium endocarditis that silently progressed in a 65-year-old man undergoing hemodialysis. Because routine monthly blood examination revealed high C-reactive protein levels, blood cultures were collected, although he had no symptom and was afebrile. After 2 days, a Gram-positive rod was detected in one set of the blood culture. Furthermore, transthoracic echocardiography revealed new aortic regurgitation (AR) and vegetations, and, therefore, infective endocarditis was suspected. Transesophageal echocardiography showed vegetations with a maximum diameter of 8 mm on his aortic valve, with some valve destruction. C. jeikeium was identified in three sets of blood cultures. Administration of daptomycin was started because he had vancomycin allergy. Judging from the high risk of embolization due to vegetations, emergency aortic valve replacement was performed on the second day. C. jeikeium was detected in a resected cardiac valve specimen and blood. This case emphasizes that physicians should always consider the possibility of infective endocarditis even in hemodialysis patients without any symptoms.


Subject(s)
Aortic Valve Insufficiency/pathology , Corynebacterium/isolation & purification , Endocarditis, Bacterial/microbiology , Renal Dialysis/adverse effects , Aged , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Antibiotics, Antitubercular/administration & dosage , Antibiotics, Antitubercular/therapeutic use , Aortic Valve/diagnostic imaging , Aortic Valve/microbiology , Aortic Valve/pathology , Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Insufficiency/surgery , Blood Culture/methods , C-Reactive Protein/analysis , Combined Modality Therapy , Daptomycin/administration & dosage , Daptomycin/therapeutic use , Diagnostic Tests, Routine/standards , Echocardiography/methods , Echocardiography, Transesophageal/methods , Endocarditis, Bacterial/blood , Endocarditis, Bacterial/drug therapy , Hematologic Tests/methods , Humans , Incidental Findings , Male , Rifampin/administration & dosage , Rifampin/therapeutic use , Treatment Outcome
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