# Diphtheria-like Pseudomembranous Corynebacterium striatum Chronic Infection of Left Ventricular Assist Device Driveline Bridged to Heart Transplantation with Dalbavancin Treatment

## TL;DR

A rare case of C. striatum infection in a heart patient was successfully treated, showing the pathogen's potential in device-related infections.

## Contribution

First reported case of pseudomembranous inflammation linked to C. striatum in a left ventricular assist device.

## Key findings

- Patient had recurrent C. striatum bacteremia despite multiple antibiotic treatments.
- Pseudomembranous tissue around the device was confirmed histopathologically.
- Dalbavancin was used successfully during heart transplantation.

## Abstract

Background and Clinical Significance: Corynebacterium striatum is an emerging multidrug-resistant pathogen increasingly implicated in infections among immunocompromised patients and patients with indwelling medical devices. Case Presentation: We report the probable first case of pseudomembranous inflammation associated with C. striatum infection in a 53-year-old male with an implanted left ventricular assist device (LVAD) awaiting heart transplantation. The patient experienced recurrent episodes of C. striatum bacteremia despite multiple courses of targeted antibiotic therapy, including vancomycin, linezolid, tedizolid, teicoplanin, and dalbavancin. During urgent heart transplantation, pseudomembranous tissue surrounding the LVAD driveline was observed, and cultures confirmed C. striatum device infection. Histopathological analysis revealed necrotic elements and Gram-positive organisms consistent with pseudomembranous inflammation. Conclusions: The case describes the diagnosis and treatment of this rare infection, highlighting the pathogenic potential of C. striatum, its role in device-related infections, and the histopathological evidence of pseudomembrane formation.