A gram-positive, coryneform bacterium was isolated from swollen scleromata of a dermatosis patient. An analysis of its phenotypic, chemotaxonomic, and genotypic characteristics showed that this bacterium is closely associated with Arthrobacter oxydans and Arthrobacter polychromogenes but that it belongs to a distinct species, for which the name Arthrobacter scleromae sp. nov. is proposed.
CASE REPORTA 19-year-old male presented to our clinic with a 2-month history of swollen scleromata on his back and hip. He complained of itching and pain at the foci of infection, especially when being touched, and of difficulties sitting and sleeping. No other relevant symptoms were present. While the patient was somewhat thin, his nutritional state was normal. He denied having any other previous illnesses of note or a family history of skin sensitivity.Scattered, dull red, swollen dermal scleromata on the patient's back and hip were noted upon examination. Some of the scleromata were as large as chicken eggs, had white pus on the tops, and oozed a bloody effusion when pierced. No lymphadenopathy was detected, and the physical examination was otherwise normal. Routine hematological investigations revealed a leukocyte count of 6.5 ϫ 10 9 cells/liter, with 38.5% lymphocytes, a hemoglobin level of 12.6 g/dl, and a platelet count of 250 ϫ 10 9 /liter. The lymphocyte T4/T8 ratio was 1.5. The serum immunoglobulin G (IgG) level was 1,120 mg/dl, the IgA level was 410 mg/dl, and the IgM level was 183 g/dl. Complement C3 was at 0.9 g/liter, C4 was at 0.75 g/liter, and CH50 was at 66.6 U. The serum HB s Ag test was negative. The scleromata developed slowly and looked like granuloma. No skin biopsy was performed. Samples of the bloody effusion were sent for bacterial, mycobacterial, and fungal cultures. A rapidly growing bacterium with numerous colonies in a pure culture state on blood agar was seen after 24 h at 35°C. The isolate was suspected of being Staphylococcus epidermidis due to colonial and cell morphology. But in succedent liquid culture, a rod coccus growth cycle was observed within 24 h at 35°C. Thus, a gram-positive coryneform bacterium, which was subsequently identified as an Arthrobacter sp., was recognized. The patient was treated with oral Chinese herbal medicine for heat clearing and detoxifying once a week for 1 month. Meanwhile, empirical antimicrobial therapy with oral ampicillin was initiated. Once the culture result was ascertained, on the fifth day from the start of the therapy, antibiotic treatment was changed to intravenous ceftriaxone and cefazolin for 2 weeks and then to oral ceftriaxone, with slow resolution of the lesion over a 2-month period.