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Background <p><i>Corynebacterium striatum</i> (<i>C. striatum</i>), a Gram-positive opportunistic pathogen, is increasingly linked to healthcare-associated pneumonia (HAP) in immunocompromised patients, but its nonspecific manifestations and multidrug resistance cause diagnostic delays. This case adds to literature by highlighting neutrophil phagocytosis in sputum smears as a pivotal clue for distinguishing <i>C. striatum</i> infection from contamination, especially in mixed infections.</p> Case summary <p>A 56-year-old female with uncontrolled diabetes, hypertension, and post-cerebral hemorrhage sequelae developed severe pneumonia, complicated by septic shock, CRRT-requiring acute kidney injury, and gastrointestinal bleeding. Initial therapy for <i>Klebsiella pneumoniae</i> and <i>Pseudomonas aeruginosa</i> failed. Sputum smear showed neutrophils phagocytosing Gram-positive rods; culture confirmed multidrug-resistant <i>C. striatum</i>. Therapy with ceftazidime-avibactam, vancomycin, and caspofungin improved outcomes.</p> Conclusion <p>Microscopic detection of phagocytosis aids early <i>C. striatum</i> identification; dynamic etiological monitoring and individualized combination therapy are critical for refractory HAP in immunocompromised patients.</p>

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Multidrug-resistant Corynebacterium striatum-induced severe pneumonia complicated with multiple organ failure: a diagnostic breakthrough guided by phagocytosis and therapeutic strategy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月21日

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  • Ruofan Wang,
  • Xiaosong Xu,
  • Zhilong Zheng,
  • Ruiying Li,
  • Xiangsheng Cai

摘要

Background

Corynebacterium striatum (C. striatum), a Gram-positive opportunistic pathogen, is increasingly linked to healthcare-associated pneumonia (HAP) in immunocompromised patients, but its nonspecific manifestations and multidrug resistance cause diagnostic delays. This case adds to literature by highlighting neutrophil phagocytosis in sputum smears as a pivotal clue for distinguishing C. striatum infection from contamination, especially in mixed infections.

Case summary

A 56-year-old female with uncontrolled diabetes, hypertension, and post-cerebral hemorrhage sequelae developed severe pneumonia, complicated by septic shock, CRRT-requiring acute kidney injury, and gastrointestinal bleeding. Initial therapy for Klebsiella pneumoniae and Pseudomonas aeruginosa failed. Sputum smear showed neutrophils phagocytosing Gram-positive rods; culture confirmed multidrug-resistant C. striatum. Therapy with ceftazidime-avibactam, vancomycin, and caspofungin improved outcomes.

Conclusion

Microscopic detection of phagocytosis aids early C. striatum identification; dynamic etiological monitoring and individualized combination therapy are critical for refractory HAP in immunocompromised patients.