An Unusual Case of Corynebacterium simulans causes Infective Endocarditis with Embolic Events

Abstract

Corynebacterium species are often treated as contaminants. However, there were several recent outbreaks involving Corynebacterium species reported across the globe. We report a rare case of Corynebacterium simulans causes infective endocarditis which led to debilitating embolic events. A 39-year-old lady presented with a prolonged fever for three weeks. She was in septic shock and had dense right hemiplegia, a pansystolic murmur at the mitral area and hepatosplenomegaly. There were no peripheral stigmata of infective endocarditis. An urgent computed tomography (CT) of the brain showed an infarct at the left corona radiata extending to the left parietal, left basal ganglia and left temporal lobe. She deteriorated and required mechanical ventilation and intensive care. Echocardiogram showed vegetation at both her anterior and posterior mitral valve leaflets leading to severe mitral regurgitation. Splenic infarction was seen in her contrasted computed tomography (CECT) of her abdomen. Her three samples of blood culture were positive for Corynebacterium simulans. She deteriorated rapidly and went into multi-organ failure and succumbed. Corynebacterium species should be taken seriously and should not be neglected as a contaminant as it can cause potentially fatal complications as described in this case report.