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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
A case of refractory mastitis caused by Corynebacterium tuberculostearicum infection in a parous young woman |
| Language |
J |
| AuthorList |
Daisuke Kitagawa1), Miyako Oka1), Kazue Masuo1), Yutaka Yoshimura1), Fumihiko Nakamura1), Akihiro Nakamura2) |
| Affiliation |
1) Department of Central Clinical Laboratory, Nara Prefecture General Medical Center
2) Department of Clinical Laboratory Science, Tenri Health Care University |
| Publication |
J.J.C.M.: 28 (2), 126-131, 2018 |
| Received |
August 28, 2017 |
| Accepted |
December 11, 2017 |
| Abstract |
Here, we report a case of mastitis where we isolated a lipophilic Corynebacterium tuberculostearicum. The patient was female and in her thirties. The right mammary gland of the patient had continued swelling and pain for one month prior to examination. After various inspections, breast cancer was not detected. Administration of antibiotics was started. However, the patient deteriorated and developed a fever; therefore, she was hospitalized. After mammary gland puncture, lipophilic Corynebacterium was detected from aspirated pus by bacteriological examination. A Gram stain of aspirated pus indicated many neutrophils and a few gram-positive bacilli, which grew slightly after 8 days' culture. Next, we used an ApiCoryne identification kit (Bionumber: 2100105) and VITEK2 ANC (Bionumber: 6363100400405) but could not identify the bacterial species. The specimens' growth was encouraged using lipid-supplemented medium. PCR targeting the Corynebacterium kroppenstedtii 16S rRNA gene was negative. Finally, C. tuberculostearicum was identified by mass spectrometry and 16S rRNA broad-range PCR analysis. The patient's symptoms were improved through drainage and treatment with antibiotic levofloxacin. C. tuberculostearicum is likely to be a pathogenic bacterium in this case. As C. tuberculostearicum is not included in the database of ApiCoryne or VITEK2, these tests cannot identify this species accurately; we consider that PCR and mass spectrometry are necessary for this. Mastitis caused by lipophilic Corynebacterium is frequently resistant to β-lactam antibacterial agents owing to their water-soluble nature. Therefore, reporting as lipophilic Corynebacterium has high clinical significance, although this species is not commonly identified using standard tests. |
| Keywords |
Corynebacterium tuberculostearicum, Corynebacterium |
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