Subacute Infective Endocarditis Caused by Corynebacte rium diphtheriae : A Case Report

RANGSIMA LOLEKHA, MD*, PRAON SUPRADISH, MD*, TA WATCHAI KIRA WITTA YA, MD**, SAKSAN SRIMAHARAJA, MD***, TAWEE CHOTPITAYASUNONDH,MD*

Affiliation : * Infectious Disease Unit, ** Cardiology Unit, *** Neurosurgery Unit, Queen Sirikit National Institute of Child Health, Bangkok, 10400, Thailand.

AbstractThe authors report an 11-year-old boy with septicemia and subacute infective endocarditis due to toxigenic-Corynebacterium diphtheriae. The patient had underlying congenital heart disease and incomplete immunization. He presented with fever, epistaxis and congestive heart failure. He received high-dose penicillin therapy and diphtheria antitoxin with clinical improvement. While he was receiving a high dose of penicillin for 1 month he developed a generalized tonic clonic seizure. A computerized tomogram revealed intracerebral and ventricular hemorrhage. Craniotomy with blood clot removal and ventriculostomy drainage were done. He died 2 days later from brain death and cardiovascular failure.

Keywords : Corynebacterium Diphtheriae, Endocarditis

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