amoxicillin-potassium-clavulanate-combination and Corynebacterium-Infections

Corynebacterium pseudodiphteriticum has been considered a very infrequent respiratory pathogen. We report three cases of pneumonia due to C. pseudodiphteriticum, describing their clinical and microbiological features. There were two patients with pre-existing chronic respiratory disease, one of their with steroidal therapy, and other associated with endotracheal intubation. The diagnostic was made by Gram stain and quantitative cultures from respiratory tract specimens. All patients were cured after treatment with amoxicillin-clavulanate, ceftriaxone and vancomycin respectively. C. pseudodiphteriticum must be consider as a possible causal agent of pneumonia in patients with underlying respiratory disease or endotracheal intubation. Antimicrobial susceptibility testing of C. pseudodiphteriticum may be useful for correct treatment of infected patients, but beta-lactam antibiotics are an appropriate therapeutic option against this bacteria.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Ceftriaxone; Corynebacterium; Corynebacterium Infections; Diabetes Mellitus, Type 1; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Female; Humans; Immunosuppressive Agents; Intubation, Intratracheal; Male; Multiple Trauma; Ofloxacin; Pneumonia, Bacterial; Prednisone; Pulmonary Disease, Chronic Obstructive; Sjogren's Syndrome; Smoking; Vancomycin

A 77-year-old farmer developed cough with sputum production, fever, bloody nasal discharge and a mass in his right maxillary sinus leading to necrotic ulceration of the sinus. Corynebacterium ulcerans, carrying the beta-phage for the diphtheria toxin and secreting the toxin, was detected microscopically and by culture from the sinusoidal and ulcer discharge. Despite immediate antimicrobial chemotherapy the patient died of pulmonary failure associated with the production of large amounts of very viscous sputum. Identification of the causative agent, pathophysiological aspects and risk factors of this unusal infection are discussed.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents; Corynebacterium; Corynebacterium Infections; Diphtheria Toxin; Fatal Outcome; Humans; Imipenem; Male; Maxillary Sinusitis; Necrosis; Ofloxacin; Peptide Fragments