Cngm is characterised by suppurative lipogranulomas that are composed of central lipid vacuoles rimmed by neutrophils and an outer cuff of epithelioid histiocytes. Cystic neutrophilic granulomatous mastitis cngm is a rare subtype of granulomatous mastitis with a highly distinct histological pattern often associated with corynebacterium species.
The Brief Case Recurrent Granulomatous Mastitis Due To Corynebacterium Kroppenstedtii Journal Of Clinical Microbiology
Corynebacterium kroppenstedtii is a true member of the genus corynebacterium but it lacks the typical mycolic acids of the cell envelope.
Corynebacterium kroppenstedtii mastitis. The diagnosis of granulomatous mastitis due to c. Clinically c kroppenstedtii has been isolated largely from female subjects with most samples resulting from breast tissue and the remainder identified in blood sputum lung and prosthetic valve infections. Corynebacterium kroppenstedtii is a lipophilic corynebacterium first described in 1998 after isolation from a sputum specimen 1.
Once considered idiopathic there is growing evidence of an association with corynebacteria infection especially in the setting of a distinct histological pattern termed cystic neutrophilic granulomatous mastitis cngm. Corynebacterium kroppenstedtiigram stain a and isolation subculture on sheep blood agar at 72 h b. Association with breast conditions especially recurrent granulomatous mastitis gm was noted subsequently 2 4.
Granulomatous mastitis gm is a rare inflammatory disease of the post lactation breast clinically mimicking breast cancer. In addition to these microbiological and pathological characteristics underrecognition of the disease association between c. Kroppenstedtii should be considered.
Kroppenstedtii grew both aerobically and anaerobically on different media 1 3 4. It was first isolated in 1998 from a human sputum sample 9 and has since occasionally been associated with human infections mainly breast abscesses and granulomatous mastitis. Abstract granulomatous lobular mastitis is a rare inflammatory breast disease affecting parous reproductive aged women.
A challenging culprit in breast abscesses and granulomatous mastitis in cases of granulomatous mastitis and breast abscess especially if recurrent infection with c. Occasional reports of bacteremia and a single report of prosthetic valve infection have also been described 2 5. Gm is microscopically characterized by formation of epithelioid granulomas and abscess suppurative granulomas with lipid droplet centered inflammation.
Kroppenstedtii which typically affects young women of reproductive age can be challenging due to the presence of few organisms in clinical specimens often limited to cystic spaces poor gram staining of corynebacteria and fastidious growth in culture on routine media which was evident from our case presentation c. 7 histopathological diagnosis demonstrates granulomatous mastitis some with mixed features such as abscess or lipogranuloma. Corynebacterium kroppenstedtii ck is known as a causative bacterium of gm and identification of ck infection within the lesion should thus be essential for confirming the diagnosis.
Kroppenstedtiiand mastitis contributes to the difficulty in making the diagnosis.
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