Infections Due to Corynebacterium kroppenstedtii With Focus on Granulomatous Lobular Mastitis for Tissue Specificity, Pathogenesis, Bacteriologic Workup, and Treatment

作者：Qiong Gan, Ding Yang, Yun Wu, Yu Zhang, Qing H. Meng, Qing Qing Ding, Huifang Lu, Samuel A. Shelburne, Richard A. Ehlers, Xiang Y. Han · 发表于：Archives of Pathology & Laboratory Medicine · 年份：2025 · DOI：10.5858/arpa.2024-0365-oa · 被引用次数：5 · 研究领域：Diphtheria, Corynebacterium, and Tetanus、Breast Lesions and Carcinomas、Milk Quality and Mastitis in Dairy Cows

Context.— Corynebacterium kroppenstedtii may cause granulomatous lobular mastitis (GLM). Yet, current understanding is limited regarding its overall clinical significance, cultivation practice, GLM pathogenesis, and antimicrobial treatment. Objective.— To report the isolation and significance of C kroppenstedtii , features of patients with GLM, pathologic findings and mechanism, bacteriologic workup, and optimal treatment. Design.— Analysis of the cases with C kroppenstedtii at The University of Texas MD Anderson Cancer Center from 2016 to March 2024 for mechanistic insights. Results.— During a period of 8 years, isolates of C kroppenstedtii were obtained from 10 women and 7 men. All of the women, with an average age of 34 years (range, 18–61 years), presented with chronic or subacute mastitis, and were subsequently diagnosed with GLM. The men, with an average age of 66 years, had neoplastic diagnoses with the bacterium being commensal in 6 cases. Thus, C kroppenstedtii shows a predilection to infect the female breast ( P < .001). Predisposing risks for GLM included childbirth in 8 women and nipple inversion in 2 women. Histopathology revealed xanthogranulomatous inflammation and Gram-positive bacilli within fat droplets or extracellularly. From GLM aspirates or tissue, the liquid culture media and/or anaerobic incubation yielded 9 of 10 isolates. Up to 14 tested strains were susceptible to vancomycin, linezolid, rifampin, and gentamicin. Nine women received extensive anti...