Kataria S, Tiwari E, Ray S, Juneja D. Corynebacterium striatum and the deceptive diagnosis in a dialysis-dependent chronic liver disease patient: A case report. World J Clin Cases 2026; 14(11): 119674 [DOI: 10.12998/wjcc.v14.i11.119674]
Corresponding Author of This Article
Deven Juneja, MD, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Research Domain of This Article
Critical Care Medicine
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Case Report
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Apr 16, 2026 (publication date) through Apr 15, 2026
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Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Kataria S, Tiwari E, Ray S, Juneja D. Corynebacterium striatum and the deceptive diagnosis in a dialysis-dependent chronic liver disease patient: A case report. World J Clin Cases 2026; 14(11): 119674 [DOI: 10.12998/wjcc.v14.i11.119674]
Sahil Kataria, Ekta Tiwari, Sumit Ray, Department of Critical Care Medicine, Holy Family Hospital, New Delhi 110025, India
Deven Juneja, Institute of Critical Care Medicine, Max Super Speciality Hospital, New Delhi 110017, India
Author contributions: Kataria S and Tiwari E contributed to patient management, data collection, literature review, and manuscript drafting; Ray S and Juneja D contributed to conceptualization, critical revision of the manuscript for important intellectual content, and overall supervision. All authors read and approved the final manuscript.
Informed consent statement: The study has provided an informed consent statement.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Deven Juneja, MD, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Received: February 4, 2026 Revised: March 4, 2026 Accepted: March 16, 2026 Published online: April 16, 2026 Processing time: 65 Days and 16.9 Hours
Abstract
BACKGROUND
Corynebacterium striatum is a non-diphtherial corynebacterium commonly regarded as commensal skin flora and frequently dismissed as a blood culture contaminant. In recent years, it has emerged as an opportunistic pathogen capable of causing severe invasive infections, including infective endocarditis, particularly in patients with indwelling intravascular devices and immune dysfunction.
CASE SUMMARY
A 46-year-old man with decompensated chronic liver disease (Child-Pugh C; Model for End-Stage Liver Disease-Na 36 on admission) and end-stage renal disease on maintenance haemodialysis presented with acute-on-chronic dyspnoea and hypotension following a recent prolonged hospitalisation and dialysis catheter placement. Initial blood cultures were sterile, and baseline echocardiography findings were normal. On day 10 of admission, he developed refractory septic shock. Repeat blood cultures grew Corynebacterium striatum in multiple sets. Transthoracic echocardiography revealed large mobile vegetations involving the mitral and tricuspid valves, with severe regurgitation, consistent with multivalvular infective endocarditis. Surgery was considered too high risk due to advanced cirrhosis (Model for End-Stage Liver Disease-Na 40) and haemodynamic instability. Despite targeted intravenous vancomycin therapy and supportive care, the patient deteriorated and succumbed to multiorgan failure.
CONCLUSION
Corynebacterium striatum should not be dismissed as a contaminant when isolated repeatedly from blood cultures in vulnerable patients. Early recognition, prompt echocardiographic evaluation, and aggressive multidisciplinary management are essential, as this seemingly benign organism can cause rapidly progressive and fatal native-valve endocarditis.
Core Tip: Corynebacterium striatum, traditionally dismissed as a blood culture contaminant, can act as an aggressive endovascular pathogen in immunocompromised and dialysis-dependent patients. This case highlights how initial clinical quiescence and negative early investigations may delay recognition of infective endocarditis. However, serial blood cultures and repeat echocardiography were crucial in establishing the diagnosis. Persistent isolation of Corynebacterium striatum in the appropriate clinical context should prompt early consideration of infective endocarditis, timely antimicrobial optimisation, and multidisciplinary evaluation, as delayed recognition may be fatal.
