Microbiology
Gram-positive rods. Sometimes called diptheroides.
C. accolens, C. afermentans ubsp. lipophilum (ANF-1), C. amycolatum, C. argentoratense, C. auris, C. coyleae, C. diphtheriae, C. glucuronolyticum, C. imitans, C. jeikeium, C. lipophiloflavum, C. macginleyi, C. matruchotii, C. minutissimum,C. mucifaciens, C. propinquum, C. pseudodiphtheriticum, C. pseudotuberculosis, C. striatum, C. ulcerans, C. urealyticum, C. xerosis, CDC cornyeform group G.
Epidemiologic Risks
Found on human skin.
Pathogenic C. ulcerans can come from dogs, cats, and pigs.
Syndromes
As a group, they cause a smattering of case reports of infections in a variety of poor hosts. Most the time a positive culture represents contamination or colonization. Maybe. There are increasing case reports to suggest various Corynebacterium are pathogens more often than we suspect. When in doubt call your local ID doctor to figure it out.
C. accolens: rare disease.
C. afermentans subsp. lipophilum (ANF-1): bacteremias.
C. amycolatum: bacteremias.
C. argentoratense.
C. auris: ? otitis.
C. coyleae: may the occasional UTI (Pubmed).
C. diphtheriae: diphtheria. Classically it an oral disease, there is a cutaneous disease in heroin users amongst others (PubMed). There are also cases in travelers to endemic areas like Africa and the Philippines (PubMed).
C. glucuronolyticum: GU infections in men.
C. imitans: ? diphtheria.
C. jeikeium: variety of nosocomial infections in poor hosts, especially associated with prosthetic materials.
C. lipophiloflavum: not much.
C. macginleyi: not much.
C. matruchotii:
C. minutissimum: Erythrasma, occasional bacteremias.
C. mucifaciens: a case of cavitary pneumonia.
C. propinquum:
C. pseudodiphtheriticum: infection of prosthetic material, pneumonia in cystic fibrosis (PubMed).
C. pseudotuberculosis: suppurative granulomatous lymphadenitis, often after exposure to cattle, goats, horses.
C. striatum: variety of nosocomial infections in poor hosts, especially associated with prosthetic materials and prior antibiotic use.
C. ulcerans: mimic's diphtheria (PubMed).
The family dog and cat can be a source (PubMed) of soft tissue infections (PubMed). It can also carry the Diptheria toxin gene and cause necrotizing pneumonia, complete with diffuse pseudomembrane in the airway (PubMed). And a case of severe conjunctivitis (Pubmed).
C. urealyticum: UTI in renal transplant patients causing an obstruction and encrusting pyelitis (PubMed). A variety of nosocomial infections in poor hosts, especially associated with prosthetic materials.
C. xerosis: a variety of nosocomial infections in poor hosts, especially associated with prosthetic materials.
Treatment
C. accolens: Penicillin, cephalosporins, erythromycin, clindamycin, tetracycline, OR aminoglycosides.
C. afermentans: vancomycin.
C. amycolatum: tetracycline OR vancomycin.
C. argentoratense: Let testing be your guide.
C. auris: ciprofloxacin, gentamicin, tetracycline, OR vancomycin.
C. coyleae: Let testing be your guide. Vancomycin.
C. diphtheriae: see diphtheria.
C. glucuronolyticum: beta- lactams, aminoglycosides, OR vancomycin.
C. imitans: Let testing be your guide.
C. jeikeium: vancomycin.
C. lipophiloflavum: Let testing be your guide.
C. macginleyi: Let testing be your guide.
C. matruchotii: Let testing be your guide.
C. minutissimum: Let testing be your guide.
C. mucifaciens: beta-lactams.
C. propinquum: Let testing be your guide.
C. pseudo diphtheriticum: tetracycline OR vancomycin.
C. pseudotuberculosis: erythromycin OR tetracycline.
C. striatum: vancomycin OR penicillin G, More MDRO strains reported.
C. ulcerans: Let testing be your guide. "Both the human and the dog C. ulcerans strains were susceptible to amoxicillin, benzyl penicillin, ceftriaxone, erythromycin, ciprofloxacin, vancomycin, linezolid, and tetracycline (PubMed)."
C. urealyticum: vancomycin.
C. xerosis: anything.
CDC cornyeform group G: Let testing be your guide.
Notes
Is the positive blood cultures the real deal? In one series, "Corynebacterium jeikeium and Corynebacterium striatum were significantly overrepresented in the group with true infection, whereas Corynebacterium afermentans" was pre likely garbage. And the real deals were usually (prosthetic valve endocarditis and had only one positive blood culture (Pubmed).
Curious Cases
Relevant links to my Medscape blog
Last Update: 11/29/19.