Non-toxigenic Corynebacterium diphtheriae endocarditis: A cluster of five cases
Southern African Journal of Infectious Diseases
| Field | Value | |
| Title | Non-toxigenic Corynebacterium diphtheriae endocarditis: A cluster of five cases | |
| Creator | Lovelock, Tamsin du Plessis, Mignon van der Westhuizen, Clinton Janson, Jacques T. Lawrence, Charlene Parker, Arifa Pecoraro, Alfonso Prozesky, Hans von Gottberg, Anne Taljaard, Jantjie | |
| Description | Background: Classical toxin-mediated respiratory diphtheria has become less common because of widespread effective vaccination globally but invasive disease as a result of non-toxigenic strains of Corynebacterium diphtheriae is not prevented by vaccination and may result in severe disease, including infective endocarditis (IE).Objectives: To describe the outbreak and subsequent investigation of a cluster of five cases of non-toxigenic C. diphtheriae endocarditis.Method: A retrospective observational case series of five cases of non-toxigenic C. diphtheriae endocarditis identified in the rural West Coast district of the Western Cape province of South Africa between May 2021 and June 2021.Results: Non-toxigenic C. diphtheriae IE had an aggressive clinical course with high mortality in this cohort. Only one of five patients survived to hospital discharge. The surviving patient received a prompt diagnosis with early surgical intervention but still had a complicated clinical course. Notably, only one case had a pre-existing risk factor for IE, namely a prosthetic valve. Whole genome sequencing of clinical isolates confirmed that all isolates were of the same novel sequence type of non-toxigenic C. diphtheriae but despite a thorough investigation no epidemiological link was ever found between the cases.Conclusion: Non-toxigenic strains of C. diphtheriae are less well known but may be highly virulent and cause severe invasive disease.Contribution: This is the largest cluster of non-toxigenic C. diphtheriae IE ever described in South Africa and expands the body of literature on this unusual but possibly emerging infection. | |
| Publisher | AOSIS Publishing | |
| Date | 2024-02-21 | |
| Identifier | 10.4102/sajid.v39i1.539 | |
| Source | Southern African Journal of Infectious Diseases; Vol 39, No 1 (2024); 7 pages 2313-1810 2312-0053 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajid.co.za/index.php/sajid/article/view/539/1388
https://sajid.co.za/index.php/sajid/article/view/539/1389
https://sajid.co.za/index.php/sajid/article/view/539/1390
https://sajid.co.za/index.php/sajid/article/view/539/1391
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