Corynebacterium striatum: Jekyll or Hyde in the lungs

A 50-year-old male patient, with Human immunodeficiency virus (HIV) and multiple co-morbidities was admitted with a fractured femur. He developed respiratory symptoms; good-quality sputum was sent for culture, which showed Gram-positive bacilli in palisades. The isolate was identified as Corynebacterium striatum (C. striatum) by Matrix-assisted laser desorption ionization time-of-flight mass spectrometry and was sensitive to Vancomycin, Linezolid, and Rifampicin. The respiratory symptoms worsened necessitating intubation. Endotracheal aspirate sent for culture and sensitivity yielded C. striatum and multi-drug resistant Acinetobacter baumannii. The patient deteriorated rapidly and succumbed to his illness. C. striatum is an opportunistic pathogen and should not be overlooked as a commensal when isolated from good-quality clinical specimens. It is an emerging pathogen in severe and often fatal pneumonia in immunocompromised patients. Recent reports of its outbreaks and multi-drug resistance are worrisome. Further investigation is required to develop effective infection control measures to prevent spread and outbreaks in health care settings.