Letter to the Editor

Cluster of Invasive Infections, Including Endocarditis, Caused by Nontoxigenic Corynebacterium diphtheriae

Authors: Anthony Kakis, DPM, Beth Hartung, MD, Larry Lambert, MPH, Robert McCabe, MD, Chung K. Marston, BS, Tanja Popovic, MD, PHD

Abstract

Nontoxigenic Corynebacterium diphtheriae is an unusual cause of deep infections such as endocarditis. We encountered a cluster of three deep infections caused by nontoxigenic C diphtheriae during a ten week period in Oakland, California. A 42-year-old, homeless, alcoholic male presented on May 14, 1999, complaining of chills, cough, weight loss, arthralgias, and night sweats. Examination revealed fever, poor hygiene, a swollen and tender right wrist, and II/VI apical systolic murmur. Three blood cultures yielded C diphtheriaebiotype gravis. Transthoracic echocardiograms showed mitral valve and aortic valve vegetations. After penicillin treatment for six weeks, he underwent mitral and aortic valve replacement for congestive heart failure, and then was lost to follow-up.

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