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Rare human skin infection with Corynebacterium ulcerans: transmission by a domestic cat

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Abstract

Corynebacterium ulcerans is mainly known for its ability to cause animal infections. Some strains of C. ulcerans produce diphtheria toxin, which can cause life-threatening cardiopathies and neuropathies in humans. Human cutaneous C. ulcerans infection is a very rare disease that mimics classical cutaneous diphtheria. We present a very rare case of a C. ulcerans skin infection caused by a non-diphtheria toxin-producing strain of C. ulcerans that resolved after 3 weeks of therapy with amoxicillin–clavulanate. A pet cat was the probable source of infection. The presence of C. ulcerans in the mouth of the cat was confirmed by 16S rRNA gene analysis and the API Coryne system. In cases of human infection with potentially toxigenic corynebacteria, it is important to determine the species and examine the isolate for diphtheria toxin production. If toxigenicity is present, diphtheria antitoxin should be administered immediately. Carriers and potential infectious sources of C. ulcerans include not only domestic livestock but also pet animals. For the primary prevention of disease caused by diphtheria toxin-producing corynebacteria, vaccination with diphtheria toxoid is recommended.

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References

  1. Meyer DK, Reboli AC. Other coryneform bacteria and rhodococcus. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. New York: Elsevier; 2005. p. 2465–78.

    Google Scholar 

  2. Tiwari TS, Golaz A, Yu DT, Ehresmann KR, Jones TF, Hill HE, et al. Investigations of 2 cases of diphtheria-like illness due to toxigenic Corynebacterium ulcerans. Clin Infect Dis. 2008;46:395–401.

    Article  PubMed  Google Scholar 

  3. Wong TP, Groman N. Production of diphtheria toxin by selected isolates of Corynebacterium ulcerans and Corynebacterium pseudotuberculosis. Infect Immun. 1984;43:1114–6.

    PubMed  CAS  Google Scholar 

  4. Lipsky BA, Goldberger AC, Tompkins LS, Plorde JJ. Infections caused by nondiphtheria corynebacteria. Rev Infect Dis. 1982;4:1220–35.

    Article  PubMed  CAS  Google Scholar 

  5. Carne HR, Onon EO. The exotoxins of Corynebacterium ulcerans. J Hyg (Lond). 1982;88:173–91.

    Article  CAS  Google Scholar 

  6. Wagner J, Ignatius R, Voss S, Höpfner V, Ehlers S, Funke G, et al. Infection of the skin caused by Corynebacterium ulcerans and mimicking classical cutaneous diphtheria. Clin Infect Dis. 2001;33:1598–600.

    Article  PubMed  CAS  Google Scholar 

  7. Bosshard PP, Abels S, Altwegg M, Böttger EC, Zbinden R. Comparison of conventional and molecular methods for identification of aerobic catalase-negative gram-positive cocci in the clinical laboratory. J Clin Microbiol. 2004;42:2065–73.

    Article  PubMed  CAS  Google Scholar 

  8. Bosshard PP, Kronenberg A, Zbinden R, Ruef C, Böttger EC, Altwegg M. Etiologic diagnosis of infective endocarditis by broad-range polymerase chain reaction: a 3-year experience. Clin Infect Dis. 2003;37:167–72.

    Article  PubMed  Google Scholar 

  9. Shi SR, Cote RJ, Wu L, Liu C, Datar R, Shi Y, et al. DNA extraction from archival formalin-fixed, paraffin-embedded tissue sections based on the antigen retrieval principle: heating under the influence of pH. J Histochem Cytochem. 2002;50:1005–11.

    Article  PubMed  CAS  Google Scholar 

  10. Bonnet JM, Begg NT. Control of diphtheria: guidance for consultants in communicable disease control. World Health Organization. Commun Dis Public Health. 1999;2:242–9.

    PubMed  CAS  Google Scholar 

  11. Hogg RA, Wessels J, Hart J, Efstratiou A, De Zoysa A, Mann G, et al. Possible zoonotic transmission of toxigenic Corynebacterium ulcerans from companion animals in a human case of fatal diphtheria. Vet Rec. 2009;165:691–2.

    PubMed  CAS  Google Scholar 

  12. De Zoysa A, Hawkey PM, Engler K, George R, Mann G, Reilly W, et al. Characterization of toxigenic Corynebacterium ulcerans strains isolated from humans and domestic cats in the United Kingdom. J Clin Microbiol. 2005;43:4377–81.

    Article  PubMed  Google Scholar 

  13. Bär W. Physiologische Bakterienflora: Kolonisationsresistenz, endogene Opportunisteninfektionen; Probiotika. In: Hahn H, Falke D, Kaufmann SHE, Ullmann U, editors. Medizinische Mikrobiologie und Infektiologie. 5th ed. Heidelberg: Springer Medizin; 2005. p. 35–44.

    Chapter  Google Scholar 

  14. Oehler RL, Velez AP, Mizrachi M, Lamarche J, Gompf S. Bite-related and septic syndromes caused by cats and dogs. Lancet Infect Dis. 2009;9:439–47.

    Article  PubMed  Google Scholar 

  15. Efstratiou A, Maple PAC. Manual for the laboratory diagnosis of diphtheria. The Expanded Programme on Immunization in the European Region of WHO. ICP/EPI038(C). Copenhagen: WHO; 1994.

  16. Soto A, Zapardiel J, Soriano F. Evaluation of API Coryne system for identifying coryneform bacteria. J Clin Pathol. 1994;47:756–9.

    Article  PubMed  CAS  Google Scholar 

  17. Clarridge J, Popovic T, Inzana T. Diphtheria and other corynebacterial and coryneform infections. In: Collier L, Balows A, Sussman M, editors. Topley and Wilson’s microbiology and microbial infections. London: Arnold; 1998. p. 348–52.

    Google Scholar 

  18. Efstratiou A, Engler KH, Dawes CS, Sesardic D. Comparison of phenotypic and genotypic methods for detection of diphtheria toxin among isolates of pathogenic corynebacteria. J Clin Microbiol. 1998;36:3173–7.

    PubMed  CAS  Google Scholar 

  19. Cassiday PK, Pawloski LC, Tiwari T, Sanden GN, Wilkins PP. Analysis of toxigenic Corynebacterium ulcerans strains revealing potential for false-negative real-time PCR results. J Clin Microbiol. 2008;46:331–3.

    Article  PubMed  CAS  Google Scholar 

  20. MacGregor RR. Corynebacterium diphtheriae. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. New York: Elsevier; 2005. p. 2457–65.

    Google Scholar 

  21. Schuhegger R, Kugler R, Sing A. Pitfalls with diphtheria-like illness due to toxigenic Corynebacterium ulcerans. Clin Infect Dis. 2008;47:288.

    Article  PubMed  Google Scholar 

  22. DeWinter LM, Bernard KA, Romney MG. Human clinical isolates of Corynebacterium diphtheriae and Corynebacterium ulcerans collected in Canada from 1999 to 2003 but not fitting reporting criteria for cases of diphtheria. J Clin Microbiol. 2005;43:3447–9.

    Article  PubMed  Google Scholar 

  23. Werchniak AE, Devlin RK, Klaus SN. Case report of a persistent skin and soft tissue infection caused by Corynebacterium ulcerans. Infect Dis Clin Pract. 2007;15:217–9.

    Article  Google Scholar 

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Acknowledgment

We thank the laboratory team of Triemli Hospital for their expert technical support.

Conflict of interest

None.

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Authors and Affiliations

  1. Outpatient Clinic of Dermatology, Triemli Hospital, Herman Greulich Strasse 70, 8004, Zurich, Switzerland

    M. A. M. Corti, S. Borelli & S. Lautenschlager

  2. Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland

    G. V. Bloemberg

  3. Dermatohistopathologische Gemeinschaftspraxis, Friedrichshafen, Germany

    H. Kutzner

  4. Department of Internal Medicine, Triemli Hospital, Zurich, Switzerland

    G. Eich

  5. Institute of Veterinary Bacteriology, University of Zurich, Zurich, Switzerland

    L. Hoelzle

Authors
  1. M. A. M. Corti
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  2. G. V. Bloemberg
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  3. S. Borelli
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  4. H. Kutzner
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  5. G. Eich
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  6. L. Hoelzle
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  7. S. Lautenschlager
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Correspondence to S. Lautenschlager.

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Corti, M.A.M., Bloemberg, G.V., Borelli, S. et al. Rare human skin infection with Corynebacterium ulcerans: transmission by a domestic cat. Infection 40, 575–578 (2012). https://doi.org/10.1007/s15010-012-0254-5

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  • DOI: https://doi.org/10.1007/s15010-012-0254-5

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