Corynebacterium ulcerans Infection of the Lung Mimicking the Histology of Churg-Strauss Syndrome

Nureki, Shin-ichi; Miyazaki, Eishi; Matsuno, Osamu; Takenaka, Ryuichi; Ando, Masayuki; Kumamoto, Toshihide; Nakano, T.; Ohkusu, Kiyofumi; Ezaki, Takayuki

doi:10.1378/chest.06-2346

Cited by 21 publications

(18 citation statements)

References 7 publications

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“…Phylogenetic analysis of C. ulcerans isolates. C. ulcerans dog isolates obtained in this study (indicated in bold) as well as Japanese human isolates reported previously (Asakura et al, 2006;Hagiwara et al, 2006;Hatanaka et al, 2003;Komiya et al, 2010;Noguchi et al, 2009;Nureki et al, 2007) were analysed by PFGE as described in Methods. The phylogenetic tree was generated by the UPGMA method.…”

Section: Discussionmentioning

confidence: 97%

“…The isolates were classified into four types (A2, B, C, D) by PFGE ( (Noguchi et al, 2009), and type A3 including 0607 (Hagiwara et al, 2006). Another human isolate, 0510 (Nureki et al, 2007), was classified in a comparatively distant type D.…”

Section: Pfge Analysismentioning

confidence: 99%

“…In Japan, eight cases of infection by toxigenic C. ulcerans in humans were reported between 2001 and 2011 (Asakura et al, 2006;Hagiwara et al, 2006;Hatanaka et al, 2003Hatanaka et al, , 2011Komiya et al, 2010;Noguchi et al, 2009;Nureki et al, 2007;Yoshimura et al, 2010). C. ulcerans causes purulent inflammatory diseases such as mastitis, lymphadenitis, dermatitis and respiratory infections in various domestic and wild animals.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Corynebacterium ulcerans in dogs in Osaka, Japan

Katsukawa

Komiya

Yamagishi³

et al. 2012

Journal of Medical Microbiology

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Diphtheria-like human illness caused by Corynebacterium ulcerans is an emerging threat in developed countries, with incidence sometimes higher than that of diphtheria caused by Corynebacterium diphtheriae. Companion animals are considered a potential source of human infections. In order to determine the prevalence of C. ulcerans among dogs, we performed a screening for the bacterium in 583 dogs in the custody of the Osaka Prefectural government. Forty-four dogs (7.5 %) were positive for the bacterium, although they did not show any clinical symptoms. All bacterial isolates showed resistance or decreased sensitivity to clindamycin, and some showed decreased sensitivity to levofloxacin. Comparative analysis of isolates using PFGE, toxin gene typing and antibiotic sensitivities suggests that transmission between asymptomatic dogs might have occurred.

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Section: Discussionmentioning

confidence: 97%

Section: Pfge Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Corynebacterium ulcerans in dogs in Osaka, Japan

Katsukawa

Komiya

Yamagishi³

et al. 2012

Journal of Medical Microbiology

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“…Patients may exhibit skin lesions that completely mimic cutaneous diphtheria or present as a tracheal-bronchial tree covered by pseudomembranes (Wagner et al 2001, Dewinter et al 2005. C. ulcerans infection may produce clinical syndromes in the lower respiratory tract (Dessau et al 1995, Nureki et al 2007), occasionally associated with signs of systemic inflammatory response syndrome and disseminated intravascular coagulation (Wellinghausen et al 2005). C. ulcerans infections may occur in children previously immunized against diphtheria (Leek et al 1990).…”

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confidence: 99%

First detection of Corynebacterium ulcerans producing a diphtheria-like toxin in a case of human with pulmonary infection in the Rio de Janeiro metropolitan area, Brazil

Mattos‐Guaraldi

Sampaio

Santos

et al. 2008

Mem. Inst. Oswaldo Cruz

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“…Using PFGE (De Zoysa et al, 1995), the isolate was genetically compared with four isolates that were representatives of four groups into which a previous study classified the Japanese strains (Katsukawa et al, 2012). The location cities from which the four C. ulcerans isolates had been reported were Chiba (strain 0102) (Hatanaka et al, 2003;Komiya et al, 2010), Okayama (strain 0509) (Asakura et al, 2006), Oita (strain 0510) (Nureki et al, 2007) and Kanagawa (strain 0607) (Hagiwara et al, 2006). The PFGE results revealed that the genotype pattern of this patient's isolate showed 96 % identity with that of the human isolate 0607 in Kanagawa.…”

mentioning

confidence: 99%

Subcutaneous abscess formation in the upper extremity caused by toxigenic Corynebacterium ulcerans

Urakawa

Seto

Yamamoto

et al. 2013

Journal of Medical Microbiology

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Corynebacterium ulcerans is attracting attention as an emerging zoonosis that causes lymphadenitis, dermatitis and respiratory infections. We report here what appears to be the first case of subcutaneous abscess formation in the upper extremity due to toxigenic C. ulcerans in Japan. Awareness of the fact that C. ulcerans can cause a subcutaneous, elastic-hard, lessmobile mass with heat, redness and pain in the extremities is important for differential diagnosis. IntroductionCorynebacterium ulcerans is known as an emerging zoonosis that causes cutaneous infection, sinusitis, tonsillitis, pharyngitis, pneumonia and peritonitis (Dias et al., 2011). However, to the best of our knowledge, C. ulcerans has not been reported to cause subcutaneous abscess in the extremities. Therefore, clinicians encountering a subcutaneous mass in the extremities are unlikely to consider subcutaneous abscesses due to C. ulcerans as a differential diagnosis. This could lead to a delay in diagnosis and treatment, and in the worst scenario, it may result in a fatal diphtheria-like disease (Mattos-Guaraldi et al., 2008;Putong et al., 2011).Here, we report the diagnosis and treatment of a patient with a subcutaneous abscess in the upper extremity due to C. ulcerans and discuss the clinical characteristics useful for differential diagnosis. Case reportIn December 2011, a 37-year-old Japanese woman was referred to Tsuruoka Municipal Shonai Hospital, in Tsuruoka, Japan, with a painful mass in her right elbow. The patient had no cardiac symptoms. Her past medical history was unremarkable. Three days before the current hospital visit, she experienced swelling and itching on the medial side of her right elbow. Within a few days, a hot, red, painful mass rapidly formed subcutaneously.Physical examination revealed redness and local heat on the surface of the skin over the mass. The mass was approximately 4 cm in size, elastic hard and less mobile, and caused pain and tenderness. No radiating pain was produced on tapping on the mass (Tinel's sign). Laboratory tests revealed an increase in C-reactive protein levels (2.3 mg dl 21) and a white blood cell count in the normal range (7500 mm 23 ). Radiography did not reveal calcification within the lesion. On magnetic resonance imaging, a subcutaneous soft tissue mass (27622626 mm in size) was observed on the medial side of her elbow; it exhibited iso-signal intensity on T1-weighted images (Fig. 1a) and inhomogeneous high-signal intensity on T2-weighted images (Fig. 1b). Following intravenous administration of gadopentetate dimeglumine, ring enhancement was seen on T1-weighted images (Fig. 1c).Fine-needle aspiration biopsy was performed. No pus was aspirated, but small fragments of tissue were obtained. The tissue fragments were sent for pathological analysis and microbiological diagnosis. Histopathological examination showed no malignancy, but neutrophils and histiocytes were present in the specimen. Bacterial cultures were negative under aerobic conditions. In January 2012, the patient underwent surgery...

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Corynebacterium ulcerans Infection of the Lung Mimicking the Histology of Churg-Strauss Syndrome

Cited by 21 publications

References 7 publications

Prevalence of Corynebacterium ulcerans in dogs in Osaka, Japan

Prevalence of Corynebacterium ulcerans in dogs in Osaka, Japan

First detection of Corynebacterium ulcerans producing a diphtheria-like toxin in a case of human with pulmonary infection in the Rio de Janeiro metropolitan area, Brazil

Subcutaneous abscess formation in the upper extremity caused by toxigenic Corynebacterium ulcerans

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