ENDOCARDITIS DUE TO CORYNEBACTERIUM-DIPHT HERIAE IN CONTACT WITH IV DRUG-ABUSE - 5 CASES

The clinical features of 5 patients with invasive disease due to nonto xigenic Corynebacterium diphtheriae are presented. 4 patients had prov en left sided endocarditis, and one had probable endocarditis of the m itral valve. 4 patients were intravenous drug abusers, and one had a g irl friend who was also an iv-drug abuser. Only one patient had antibo dies against human immunodeficiency virus. 2 patients with endocarditi s of the mitral or the aortic valve, and one patient with endocarditis of a prosthetic aortic valve, died oi septic complications. All patie nts or their partners frequented the same community of drug abusers, S ince the blood culture isolates shared common features for biotyping, resistance patterns and also for ribotyping in three tested patients, we assume that all patients were infected by the same clone of C. diph theriae. Drug abusers may become a new reservoir for C. diphtheriae in fection. Along with our patients, we present an overview of the 49 pub lished cases of C. diphtheriae endocarditis.