Multiple Septic Emboli in the Skin, Lungs, and Brain due to Corynebacterium Striatum Bacteremia in a Patient with Acute Myelogenous Leukemia

Motoharu Shibusawa^1, , Jiro Tadokoro¹, Shouhei Sato¹ and Makoto Kashimura¹

¹Shinmatsudo Central General Hospital, Department of Hematology

Cite this paper

Motoharu Shibusawa, Jiro Tadokoro, Shouhei Sato and Makoto Kashimura. Multiple Septic Emboli in the Skin, Lungs, and Brain due to Corynebacterium Striatum Bacteremia in a Patient with Acute Myelogenous Leukemia. American Journal of Medical Case Reports. 2018; 6(12):241-246. doi: 10.12691/AJMCR-6-12-4

Abstract

A 29-year-old man developed fever after chemotherapy for acute myelogenous leukemia. Corynebacterium striatum was detected via blood culture, and antibacterial treatment with vancomycin started. In the course of treatment, papules of the skin, multiple nodular shadows of the lung, cerebral infarction, and subdural empyema appeared. A diagnosis of multiple septic emboli in the skin, lungs, and brain due to C. striatum bacteremia was made from the clinical course. The antibacterial treatment improved skin and pulmonary lesions. The subdural empyema was considered as a postoperative infection of burr-hole craniotomy. It improved by performing craniotomy twice with drainage and empiric antibiotic therapy. In our case, neutropenia was present as an immunodeficiency, which made bacteremia severe. There has not been reported a case of septic emboli of three lesions; skin, lung, and brain. C. striatum bacteremia may result in septic emboli and should immediately be treated with antibiotics.

Keywords

Corynebacterium striatum, acute myelogenous leukemia, septic emboli

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Brouwer, M. C., Tunkel, A. R., McKhann, G. M., 2nd and van de Beek, D., “Brain abscess”. N Engl J Med, 371(5). 447-56, Jul 31 2014.
[2]	Rose, Kim and Annette C, Reboli, Other Coryneform Bacteria and Rhodococci., in Mandell, Douglas, and Bennett's principles and practice of infectious disease, Elsevier, Philadelphia, 2015, 2373-2376.
[3]	Ye, R., Zhao, L., Wang, C., Wu, X. and Yan, H., “Clinical characteristics of septic pulmonary embolism in adults: a systematic review”. Respir Med, 108(1). 1-8, Jan 2014.
[4]	Delgado-Jimenez, Y., Fraga, J., Requena, C., Requena, L., Aragues, M., Fernandez Herrera, J. and Garcia Diez, A., “Acute bacterial septic vasculopathy”. Int J Dermatol, 52(9). 1071-80, Sep 2013.
[5]	Kimura, S. I., Gomyo, A., Hayakawa, J., Akahoshi, Y., Harada, N., Ugai, T., Komiya, Y., Kameda, K., Wada, H., Ishihara, Y., Kawamura, K., Sakamoto, K., Sato, M., Terasako-Saito, K., Kikuchi, M., Nakasone, H., Kanda, J., Kako, S., Tanihara, A. and Kanda, Y., “Clinical characteristics and predictive factors for mortality in coryneform bacteria bloodstream infection in hematological patients”. J Infect Chemother, 23(3). 148-153, Mar 2017.
[6]	Severo, C. B., Guazzelli, L. S., Barra, M. B., Hochhegger, B. and Severo, L. C., “Multiple pulmonary nodules caused by Corynebacterium striatum in an immunocompetent patient”. Rev Inst Med Trop Sao Paulo, 56(1). 89-91, Jan-Feb 2014.
[7]	Sato, K. and Uchiyama, M., “Corynebacterium jeikeium bacteraemia and pulmonary infiltrates in a patient with acute myelogenous leukaemia”. BMJ Case Rep, 2012. Mar 20 2012.
[8]	Sarrazin, J. L., Bonneville, F. and Martin-Blondel, G., “Brain infections”. Diagn Interv Imaging, 93(6). 473-90, Jun 2012.
[9]	Tunkel, Allan R., Subdural Empyema, Epidural Abscess, and Suppurative Intracranial Thrombophlebitis, in Mandell, Douglas, and Bennett's principles and practice of infectious disease, Elsevier, Philadelphia, 2015, 1177-1180.