Journal of Health and Medical Sciences
Published: 12 July 2021
Chronic Breast Abscess Caused by Corynebacterium Kroppenstedtii
Priyancaa Jeyabaladevan, Fawz Kazzazi, Amr Ghanim
Barts Health NHS Trust
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Keywords: Breast Abscess, Mastitis, Corynebacterium, C. Kroppenstedtii
Corynebacterium is being increasingly isolated in specimens to be proven as a causative organism in clinical disease, especially breast abscesses and mastitis. Specifically, Corynebacterium kroppenstedtii lacks the typical mycolic acids of the cell envelope, requiring lipid rich areas to grow, hence the mammary areas being ideal for its proliferation. Conservative treatment is routinely first line in breast abscess, however commonly prescribed antibiotics such as beta lactams and fluoroquinolones, are hydrophilic and do not penetrate in lipid rich environments such as the breast, thus patients are left partially treated without complete resolution of the disease process. This case report highlights the importance of considering C. kroppenstedtii, especially if recurrent infection is seen. Microbiologists should be alerted to specialized growth conditions and tools for appropriate culture such that clinicians can use a multimodal approach with early surgical intervention alongside antibiotic treatment to maximize clinical cures and reduce recurrence.
Lewis, Cecil M Jr et al. “The Human Microbiome Project: lessons from human genomics.” Trends in microbiology vol. 20,1 (2012): 1-4. doi:10.1016/j.tim.2011.10.004
Turnbaugh, P., Ley, R., Hamady, M. et al. The Human Microbiome Project. Nature 449, 804–810 (2007). https://doi.org/10.1038/nature06244
Taylor, Graeme B et al. “A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis.” Pathology vol. 35,2 (2003): 109-19.
Baumgart, Meike et al. “IpsA, a novel LacI-type regulator, is required for inositol-derived lipid formation in Corynebacteria and Mycobacteria.” BMC biology vol. 11 122. 30 Dec. 2013, doi:10.1186/1741-7007-11-122
Collins, M. D., Falsen, E., Akervall, E., Sjoden, B., & Alvarez, A. (1998). Note: Corynebacterium kroppenstedtii sp. nov., a novel corynebacterium that does not contain mycolic acids. International Journal of Systematic Bacteriology,48(4), 1449-1454. doi:10.1099/00207713-48-4-1449
Tippelt, A., Mollmann, S., Albersmeier, A., Jaenicke, S., Ruckert, C., & Tauch, A. (2014). Mycolic Acid Biosynthesis Genes in the Genome Sequence of Corynebacterium atypicum DSM 44849. Genome Announcements,2(4). doi:10.1128/genomea.00845-14
Renshaw, Andrew A et al. “Cystic neutrophilic granulomatous mastitis: an underappreciated pattern strongly associated with gram-positive bacilli.” American journal of clinical pathology vol. 136,3 (2011): 424-7. doi:10.1309/AJCP1W9JBRYOQSNZ
Tauch, Andreas & Fernandez-Natal, M. & Soriano, Francisco. (2016). A microbiological and clinical review on Corynebacterium kroppenstedtii. International Journal of Infectious Diseases. 48. 10.1016/j.ijid.2016.04.023.
Riegel, P., Liégeois, P., Chenard, M., Mathelin, C., & Monteil, H. (2004). Isolations of Corynebacterium kroppenstedtii from a breast abscess. International Journal of Medical Microbiology,294(6), 413-416. doi:10.1016/j.ijmm.2004.07.013
Fernández-Natal, Maria Isabel et al. “Draft Genome Sequences of Corynebacterium kroppenstedtii CNM633/14 and CNM632/14, Multidrug-Resistant and Antibiotic-Sensitive Isolates from Nodules of Granulomatous Mastitis Patients.” Genome announcements vol. 3,3 e00525-15. 21 May. 2015, doi:10.1128/genomeA.00525-15
Dobinson, Hazel C et al. “Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species.” Journal of clinical microbiology vol. 53,9 (2015): 2895-9. doi:10.1128/JCM.00760-15
Kataria, Kamal et al. “Management of lactational mastitis and breast abscesses: review of current knowledge and practice.” The Indian journal of surgery vol. 75,6 (2013): 430-5. doi:10.1007/s12262-012-0776-1