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Pseudoclavibacter-like subcutaneous infection: a case report.

ABSTRACT: BACKGROUND: Arthrobacter-like organisms, including Pseudoclavibacter organisms, have rarely been documented as being responsible for infection in humans. CASE PRESENTATION: An 81-year-old French man developed a subcutaneous infection despite antibiotic treatment combining clindamycin and metronidazole for chronic wound infection. A skin biopsy showed numerous polymorphonuclear cells and no bacteria, but a subcutaneous swab yielded numerous polymorphonuclear cells, a few Gram-positive cocci, Gram-negative cocci, and Gram-positive rods. The Gram-positive rod sequence exhibited 99% sequence similarity with uncultured Pseudoclavibacter sp. [GenBank:EF419350] and 99% sequence similarity with uncultured Pseudoclavibacter sp. [GenBank:EF419347]. The genetic data and unique peptide profile of this Pseudoclavibacter-like isolate, determined by matrix-assisted laser desorption ionization-time of flight mass spectrometry, underscored its uniqueness. CONCLUSIONS: Pseudoclavibacter-like organisms are identifiable in cutaneous and subcutaneous infections in humans.

SUBMITTER: Lemaitre F

PROVIDER: S-EPMC3189147 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Pseudoclavibacter-like subcutaneous infection: a case report.

Lemaitre François F Stein Andreas A Raoult Didier D Drancourt Michel M

Journal of medical case reports 20110920

<h4>Background</h4>Arthrobacter-like organisms, including Pseudoclavibacter organisms, have rarely been documented as being responsible for infection in humans.<h4>Case presentation</h4>An 81-year-old French man developed a subcutaneous infection despite antibiotic treatment combining clindamycin and metronidazole for chronic wound infection. A skin biopsy showed numerous polymorphonuclear cells and no bacteria, but a subcutaneous swab yielded numerous polymorphonuclear cells, a few Gram-positiv ...[more]

PMID: 21933406

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Project description:IntroductionSarcoidosis is a common, multisystemic non-caseating granulomatous disease of unknown etiology with cutaneous lesions present in about one-fourth of patients. Darier Roussy sarcoidosis is a rare variant of sarcoidosis with distinct cutaneous presentation characterized by multiple deep-seated nodules on the trunk and extremities which could either be asymptomatic or may present mild tenderness.Case presentationA case of 35 yrs male with cough and fever for 3 months was initially diagnosed as a case of tubercular lymphadenitis and started with ATT following which ATT-associated cutaneous adverse drug reaction was suspected due to development of rashes with generalized redness and mild itching a few weeks after starting ATT. He then developed multiple, skin-colored, deep-seated, subcutaneous lesions over the legs then over the arms, forearms, thigh, and trunk. FNAC and histopathological examination of the lesions revealed non-caseating granulomas composed localized to the subcutaneous tissue. A diagnosis of subcutaneous sarcoidosis was made. Subsequently, steroid therapy was started.DiscussionClinical manifestations of sarcoidosis range from asymptomatic (mostly) to progressive and relapsing disease. A family history of the disease raises the risk; those with one afflicted first-degree relative face a 3.7-fold increase in risk. Sarcoidosis is diagnosed based on three key criteria: a consistent clinical presentation, the discovery of non-necrotizing granulomatous inflammation in one or more tissue samples with confirmed histology, and the elimination of other origins of granulomatous disorders. . Diagnosis should be confirmed with a biopsy of the lesion, with the histological finding of non-caseating granuloma.ConclusionClinically localized subcutaneous sarcoidosis can be confused with ATT induced drug reaction due to the difficulties in diagnosing granulomatous skin disease. The prognosis is good with subcutaneous disease and if there are no disfiguring skin lesions or other critical organ involvement, corticosteroid therapy might suffice.

Dataset Information

Pseudoclavibacter-like subcutaneous infection: a case report.

Publications

Pseudoclavibacter-like subcutaneous infection: a case report.

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