Corynebacterium JK: a new pathogen in ventriculostomy infections

Corynebacterium minutissimum infecting pseudomeningocele: a rare case

Invasive infections by Corynebacterium minutissimum are rarely documented. The significance of laboratory isolation of this bacterium from a sterile specimen such as cerebrospinal fluid is difficult to determine as it usually colonizes the skin. However, repeated isolation in a clinical setting should be treated appropriately. Here we report a first case of infected pseudomeningocele by C. minutissimum in an adult woman operated on for falcotentorial psammomatous meningioma. The patient was treated successfully with linezolid.

Improving the role of intraventricular antimicrobial agents in the management of meningitis

PURPOSE OF REVIEW

The aim is to review the role of intraventricular administration of antimicrobial agents in the treatment of patients with bacterial and fungal meningitis.

RECENT FINDINGS

This article discusses indications for intraventricular antimicrobial agents, choice of antibiotics, strategies to monitor pharmacokinetics of central nervous system compartments and unanswered issues for this management approach.

SUMMARY

Intraventricular administration of antimicrobials may be necessary in certain difficult- to- eradicate central nervous system infections. There is a significant need for clinical trials and management guidelines in this area.

Corynebacterium CDC group JK (Corynebacterium jeikeium) sepsis in haematological patients: a report of three cases and a systematic literature review

We describe 3 patients with Corynebacterium jeikeium sepsis in neutropenic phase during treatment for acute myeloid leukaemia. Fever was the first symptom. All had a central venous catheter which was removed. Two patients developed subcutaneous nodules containing pus when the neutrophil count recovered; 1 had intracutaneous and pulmonary lesions. They were treated with vancomycin and recovered when the neutrophil count started to rise. A review of 80 neutropenic patients with C. jeikeium sepsis reported in the literature, together with our 3 cases indicates that risk factors for infection are the presence of a central venous catheter, being an adult male or postmenopausal female, profound and prolonged neutropenia and exposure to multiple antibiotics. Skin lesions are reported in 48% and pulmonary lesions in 36% of the patients. The overall mortality is 34% but in patients with recovery of the bone marrow only 5%. Therefore haematopoietic growth factors should be considered in neutropenic patients with C. jeikeium infection.