An 18-year-old woman presented to our institution with fever, bilateral flank pain, headache and photophobia. She had a previous atrial septal defect (ASD) closure device inserted at the age of 9 years. Blood cultures on admission were positive for Corynebacterium diphtheriae, and transoesophageal echocardiogram (TOE) revealed an echodensity associated with the ASD closure device, most consistent with a vegetation. She was treated for infective endocarditis with 6 weeks of intravenous benzylpenicillin, and follow-up TOE showed resolution of the echodensity. To our knowledge, no cases of C. diphtheriaeendocarditis of an ASD closure device have previously been reported.
- clinical diagnostic tests
- cardiovascular medicine
- infectious diseases
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Contributors All the authors have contributed to the writing, reviewing, editing and agree on the final version for submission. JN contributed the initial write-up, discussion and literature review, with TD providing further writing of the case presentation, investigations, treatment and outcome. JM was the cardiology consultant involved in the writing, cardiology perspective of treatment and follow-up. He contributed the echocardiogram images included in this article. ND provided infectious disease input, including writing contribution in respect to interpretation of microbiological results, and to the discussion of the relevant microbiology, local epidemiology and aetiology of the condition. All four authors were involved in the editing, re-writing and approval of the final version of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Obtained.
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