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1/224. corynebacterium pseudodiphtheriticum: an easily missed respiratory pathogen in hiv-infected patients.

    Despite being a well-known respiratory pathogen for immunocompromised patients, corynebacterium pseudodiphtheriticum has uncommonly been reported to occur in persons with infection attributable to hiv virus. We report three cases of respiratory tract infection attributable to C. pseudodiphtheriticum in hiv-infected patients and review the four previous cases from the medical literature. All of them were male with a median cd4 lymphocyte count of 110 cells/mm3 (range, 18-198/mm3); five of the seven cases occurred in persons for whom AIDS was diagnosed previously. The onset of symptomatology was usually acute and the most common radiographic appearance was alveolar infiltrate (six patients) with cavitation (two patients) and pleural effusion (two patients). In five of the seven cases, C. pseudodiphtheriticum was isolated from bronchoscopic samples and in the remaining two cases was recovered from lung biopsy (one patient) and sputum (one patient). In the three patients reported herein and in one previous case from the medical literature, quantitative culturing of bronchoscopic samples obtained through either bronchoalveolar lavage or protected brush catheter procedures yielded more than 10(3) CFU/mL. All the strains tested were susceptible to penicillin and vancomycin. Resistance to macrolides was common. Recovery was observed in six of the seven patients. C. pseudodiphtheriticum should be regarded as a potential respiratory pathogen in hiv-infected patients. This infection presents late in the course of hiv disease and it seems to respond well to appropriate antibiotic treatment in most of the cases. This easily overlooked pathogen should be added to the list of organisms implicated in respiratory tract infections in this population. ( info)

2/224. Septic arthritis caused by corynebacterium amycolatum following vascular graft sepsis.

    A case of septic arthritis caused by corynebacterium amycolatum in a native hip joint occurred in an adult man following contralateral vascular graft sepsis, and was successfully treated with intravenous vancomycin followed by oral doxycycline and rifampicin. To the authors' knowledge, this is the only reported case of septic arthritis due to C. amycolatum. ( info)

3/224. corynebacterium pseudodiphtheriticum pneumonia in an immunocompetent patient.

    corynebacterium pseudodiphtheriticum is a coryneform and diphtheromorphic bacteria rarely found as a cause of pneumonia in immunocompetent hosts. A case of an immunocompetent patient with C. pseudodiphtheriticum pneumonia is presented. This infection responded well to initial empirical treatment with cefotaxime. Very few cases of pneumonia associated with C. pseudodiphtheriticum have been described in the medical literature, this organism mainly being found in immunocompromised hosts. We report a case of pneumonia in an immunocompetent patient in which C. pseudodiphtheriticum was the only micro-organism isolated. ( info)

4/224. CT and MRI findings in primitive pituitary abscess: a case report and review of literature.

    Pituitary abscess is not rare. Clinical and radiological features in a primitive pituitary abscess are reported. Transphenoidal surgery revealed an abscess. Preoperative diagnosis of pituitary abscess remains difficult. Sellar round cystic mass isointense to grey matter on T1, high intensity signal on T2, with a peripheral rim enhancement following gadolinium injection associated with thickened stalk and diabetes insipidus may be suggestive of pituitary abscess. ( info)

5/224. A case of costochondral abscess due to corynebacterium minutissimum in an hiv-infected patient.

    corynebacterium minutissimum, known as the causative agent of erythrasma, has recently been reported as a clinically significant pathogen in the immunocompromised host. We report for the first time the possible involvement of a multidrug-resistant C. minutissimum strain in a costochondral abscess occurring in an hiv-infected patient. ( info)

6/224. Chronic cystitis caused by corynebacterium urealyticum detected by polymerase chain reaction.

    The case of a 73-year-old man with chronic cystitis due to corynebacterium urealyticum was complicated by hematuria and urinary stone formation. The diagnosis was based on an amplification product obtained using polymerase chain reaction for mycobacterial species on urine and a bladder biopsy specimen. A specific 212 bp amplification fragment that did not hybridize with a mycobacterium-specific probe was recognized. sequence analysis of the fragment revealed corynebacterium urealyticum. Routine urine cultures were negative, but prolonged culture on sheep blood agar led to the isolation and identification of corynebacterium urealyticum. Identification was confirmed by polymerase chain reaction on the colonies. The patient was treated successfully with vancomycin. Integration of molecular laboratory diagnostics with conventional microbiology and pathology was synergistic for the diagnosis. ( info)

7/224. Epithelial infectious crystalline keratopathy.

    PURPOSE: To report 2 cases of epithelial infectious crystalline keratopathy. methods: Two patients (2 eyes) with significant meibomitis presented with minimal inflammation and plaque-like lesions on the corneal surface made of fine crystalline structures. Corneal scrapings of these lesions were performed for microbiological evaluation. The patients were treated with topical ciprofloxacin and artificial tears. RESULTS: Smear examination of the corneal scrapings revealed numerous bacteria and keratinized epithelial cells with no inflammatory cells. culture showed a significant growth of staphylococcus epidermidis and corynebacterium species in the first case and pseudomonas aeroginosa in the second case. The response to treatment was poor, with recurrence of the crystalline lesion. CONCLUSION: Infectious crystalline keratopathy lesions may involve the epithelium and occur on the corneal surface. ( info)

8/224. Isolation and characterization of a black-pigmented corynebacterium sp. from a woman with spontaneous abortion.

    An unusual black-pigmented coryneform bacterium was isolated from the urogenital tract of a woman who experienced a spontaneous abortion during month 6 of pregnancy. Biochemical and chemotaxonomic analyses demonstrated that the unknown bacterium belonged to the genus corynebacterium. Phylogenetic analysis based on 16S rRNA sequences (GenBank accession no. AF220220) revealed that the organism was a member of a distinct subline which includes uncultured corynebacterium MTcory 1P (GenBank accession no. AF115934), derived from prostatic fluid, and corynebacterium CDC B8037 (GenBank accession no. AF033314), an uncharacterized black-pigmented coryneform bacterium. On the basis of chemotaxonomic and phylogenetic evidence, this organism probably represents a new species and is most closely related to the uncharacterized Centers for disease Control and Prevention group 4 coryneforms. Our strain is designated CN-1 (ATCC 700975). ( info)

9/224. corynebacterium jeikeium native valve endocarditis following femoral access for coronary angiography.

    We present a unique case of rapidly fatal native aortic-valve endocarditis due to corynebacterium jeikeium, with inoculation as a complication of repeated femoral vascular access for coronary angiography. ( info)

10/224. corynebacterium pseudodiphtheriticum keratitis and conjunctivitis: a case report.

    A case of keratitis and conjunctivitis in an 86-year-old man caused by corynebacterium pseudodiphtheriticum is reported. Corynebacteria are uncommon causes of ocular surface infections. However, the presence of corneal and conjunctival epithelial defects in an immunocompromised patient can result in severe infection by a commensal organism such as C. pseudodiphtheriticum. The significance of a positive culture in these settings should not be overlooked. ( info)
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