<i>Corynebacterium striatum</i> Infection in Incision and Thoracic Cavity with Concurrent CRKP Colonization Following Lung and Bladder Tumor Resection

Corynebacterium striatum, a commensal of skin and mucosa, is an emerging opportunistic pathogen. We report a rare case of postoperative incision and thoracic infection caused by C. striatum with concurrent pulmonary colonization by carbapenem-resistant Klebsiella pneumoniae (CRKP). Following resection of lung and bladder tumours, the patient developed fever, pleural effusion, and poor wound healing. Sputum cultures suggested CRKP colonization, while pleural fluid cultures identified C. striatum as the true pathogen. Clinical pharmacy consultation was pivotal in resolving this diagnostic dilemma. Guided by literature review and clinical presentation, targeted vancomycin therapy against C. striatum was initiated, leading to successful infection control. This case highlights that C. striatum should be considered a potential pathogen in postoperative patients with malignancy or invasive procedures. It is often multidrug-resistant but susceptible to glycopeptides like vancomycin. When multidrug-resistant organisms such as CRKP are also present, a comprehensive assessment integrating clinical, microbiological, and imaging data is essential to distinguish colonization from infection. This precision prevents unnecessary broad-spectrum antibiotic use, curbs resistance, and underscores the critical role of clinical pharmacists in managing complex infections through multidisciplinary collaboration.