Arcanobacterium haemolyticum was isolated from the blood cultures of a previously healthy 37-year-old man who met all the criteria of Lemierre syndrome, including a primary oropharyngeal infection, evidence of thrombophlebitis of the internal jugular vein, and metastatic infections. To the best of our knowledge, this is the first case of Lemierre syndrome caused by A. haemolyticum in Korea and shows that A. haemolyticum alone can cause Lemierre syndrome.
Arcanobacterium ; Jugular Veins ; Korea ; Lemierre Syndrome ; Thrombophlebitis

Adult ; Arcanobacterium ; pathogenicity ; Endocarditis ; microbiology ; Humans ; Male ; Young Adult

Arcanobacterium haemolyticum is a gram-positive bacillus that is most commonly implicated in pharyngitis and infections of the skin and soft tissue. Systemic and deep-seated infections caused by this organism are rarely reported in the literature. Recently, we encountered two cases of invasive infections caused by A. haemolyticum. We describe two cases, one with vertebral osteomyelitis with an epidural abscess and the other with a buttock abscess with bacteremia.
Abscess ; Adult ; Arcanobacterium ; Bacillus ; Bacteremia ; Buttocks ; Epidural Abscess ; Humans ; Osteomyelitis ; Pharyngitis ; Skin

Recently, we experienced a case of subacute infective endocarditis caused by A. haemolyticum on mitral valve prolapse complicated with systemic emboli, which was successfully treated with antibiotics and valve replacement surgery. To our knowledge, this is the first report to address infective endocarditis caused by A. haemolyticum in a immunocompetent patient who had mitral valve prolapse and survived with successful treatment. Greater awareness of this uncommon organism is needed to make an accurate diagnosis and perform a better clinical management in the early stage of the disease. Recommendation for the treatment of septic A. haemolyticum infections has not been established. Therefore, the treatment should be based on clinical experiences and in vitro susceptibility profiles of the individual strain. The site of infection as well as antimicrobial susceptibility profiles should be considered for appropriate antibiotics choice and decision to perform a surgical intervention.
Anti-Bacterial Agents ; Arcanobacterium* ; Diagnosis ; Endocarditis* ; Humans ; Mitral Valve Prolapse* ; Mitral Valve*

Recently, we experienced a case of subacute infective endocarditis caused by A. haemolyticum on mitral valve prolapse complicated with systemic emboli, which was successfully treated with antibiotics and valve replacement surgery. To our knowledge, this is the first report to address infective endocarditis caused by A. haemolyticum in a immunocompetent patient who had mitral valve prolapse and survived with successful treatment. Greater awareness of this uncommon organism is needed to make an accurate diagnosis and perform a better clinical management in the early stage of the disease. Recommendation for the treatment of septic A. haemolyticum infections has not been established. Therefore, the treatment should be based on clinical experiences and in vitro susceptibility profiles of the individual strain. The site of infection as well as antimicrobial susceptibility profiles should be considered for appropriate antibiotics choice and decision to perform a surgical intervention.
Anti-Bacterial Agents ; Arcanobacterium* ; Diagnosis ; Endocarditis* ; Humans ; Mitral Valve Prolapse* ; Mitral Valve*

Anti-Bacterial Agents ; therapeutic use ; Anticoagulants ; therapeutic use ; Arcanobacterium ; isolation & purification ; Humans ; Lemierre Syndrome ; drug therapy ; microbiology ; Male ; Middle Aged

Arcanobacterium haemolyticum is a catalase-negative, aerobic gram-positive rod. It causes pharyngitis, skin and soft tissue infection, osteomyelitis, endocarditis, meningitis, pneumonia, and septicemia. We experienced a case of A. haemolyticum bacteremia and osteomyelitis in a diabetic patient. The organism was misidentified as Cellulomonas species by automated system but correctly identified as A. haemolyticum by 16s rRNA sequencing.
Arcanobacterium ; Bacteremia ; Cellulomonas ; Endocarditis ; Humans ; Meningitis ; Osteomyelitis ; Pharyngitis ; Pneumonia ; RNA ; Sepsis ; Sequence Analysis ; Skin ; Soft Tissue Infections

Arcanobacterium haemolyticum is a cause of chronic skin ulcers in diabetic patients and respiratory infection, especially pharyngitis in healthy person. Less frequently, it is a cause of osteomyelitis, meningitis, pneumonia, abscess, endocarditis and sepsis. We isolated A. haemolyticum from 5 patients including foot or back ulceration in 3 diabetic patients, wound on calcaneus in a chronic osteomyelitis patient and peritonsillar abscess in a pharyngitis patient. A. haemolyticum is usually isolated with other microorganisms and coryneform bacilli which are often considered to be nonpathogenic normal flora or contaminants in wound infections. The correct diagnosis of this microorganism is important for proper treatment and prevention of serious infections.
Abscess ; Arcanobacterium* ; Calcaneus ; Diagnosis ; Endocarditis ; Foot ; Humans ; Meningitis ; Osteomyelitis ; Peritonsillar Abscess* ; Pharyngitis ; Pneumonia ; Sepsis ; Skin Ulcer* ; Ulcer ; Wound Infection ; Wounds and Injuries

Arcanobacterium haemolyticum, a aerobic Gram-positive rod, has been described as an unusual pathogen causing soft tissue infections such as pharyngotonsillitis, chronic ulcer and cellulitis. In addition, the microorganism causes deep-seated infection and systemic disease including endocarditis, vertebral osteomyelitis and sepsis in patients with predisposing conditions such as diabetes mellitus. Since colonies and microscopic findings of A. haemolyticum might be confused with those of streptococci and coryneform bacteria, and it is usually isolated with other microorganisms, it is often considered to be normal flora or a contaminant in wound infections, resulting in missed or delayed diagnosis. Streptococcus agalactiae infections in neonates and pregnant women have been well recognized. However, invasive S. agalactiae infections in non-pregnant older adults with chronic medical conditions, particularly diabetes mellitus, are increasing. We report a case of diabetic foot ulcer due to A. haemolyticum and S. agalactiae in an uncontrolled diabetes mellitus patient.
Adult ; Arcanobacterium ; Bacteria ; Cellulitis ; Delayed Diagnosis ; Diabetes Mellitus ; Diabetic Foot ; Endocarditis ; Female ; Humans ; Infant, Newborn ; Osteomyelitis ; Pregnant Women ; Sepsis ; Soft Tissue Infections ; Streptococcus ; Streptococcus agalactiae ; Ulcer ; Wound Infection

Arcanobacterium haemolyticum is a beta-hemolytic coryneform bacillus. It has been implicated as an etiologic agent of non-streptococcal pharyngitis and less frequently a cause of skin and wound infections, osteomyelitis, pneumonia, endocarditis, sepsis, and central nervous system infections. We describe a case of A. hemolyticum sepsis reported for the first time in Korea. A 61-year-old man with a diabetic foot was admitted due to a high fever. Three sets of blood cultures taken at the emergency room yielded coryneform bacilli. The organism was beta-hemolytic on blood agar plate, catalase-negative, and non-motile. It was identified as A. haemolyticum by Rapid CB Plus (Remel, Kansas, USA) and API Coryne (BioMerieux SA, Marcy l`Etoile, France) and confirmed by CAMP inhibition reaction. It was susceptible to penicillin, ceftriaxone, erythromycin, ciprofloxacin, and vancomycin by the disk diffusion method using the breakpoint criteria of National Committee for Clinical Laboratory Standards for streptococci other than Streptococcus pneumoniae. The patient was improved with partial amputation of the right big toe and antimicrobial therapy with ampicillin/sulbactam. If Arcanobacterium is isolated from normally sterile sites or culture specimens properly collected from infected tissues, it should be identified to the species level. Commercial biochemical test kits specialized in corynebacteria and CAMP test are useful for species identification of A. haemolyticum.
Agar ; Amputation ; Arcanobacterium* ; Bacillus ; Ceftriaxone ; Central Nervous System Infections ; Ciprofloxacin ; Diabetic Foot ; Diffusion ; Emergency Service, Hospital ; Endocarditis ; Erythromycin ; Fever ; Humans ; Kansas ; Korea ; Middle Aged ; Osteomyelitis ; Penicillins ; Pharyngitis ; Pneumonia ; Sepsis* ; Skin ; Streptococcus pneumoniae ; Toes ; Vancomycin ; Wound Infection