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Corynebacterium kroppenstedtii: a challenging culprit in breast abscesses and granulomatous mastitis

Nidhi Saraiya1, Marilou Corpuz1,2

  • 1Department of Pharmacy, Montefiore Medical Center, Wakefield Division.

Current Opinion in Obstetrics & Gynecology
|April 5, 2019
PubMed
Abstract

Insights

Corynebacterium kroppenstedtii causes difficult-to-treat breast infections. A multimodal approach combining surgery and antibiotics is recommended for granulomatous mastitis and abscesses to improve outcomes.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Surgical Pathology

Background:

  • Corynebacterium kroppenstedtii is an emerging pathogen linked to granulomatous mastitis and recurrent breast abscesses.
  • Historically prevalent in Maori and Pacific Islander women, C. kroppenstedtii infections are now reported globally, including in nulliparous individuals.
  • Hyperprolactinemia is identified as a potential modifiable risk factor for C. kroppenstedtii breast infections.

Observation:

  • Diagnosis requires specialized microbiological culturing and identification techniques.
  • Clinical presentation includes granulomatous mastitis and recurrent breast abscesses.
  • Treatment challenges persist due to lack of established guidelines for surgical interventions, steroid use, and antibiotic regimens.

Findings:

  • A review of 87 cases and a patient case highlights current best practices for diagnosis, treatment, and monitoring.
  • Multimodal treatment, incorporating both surgical intervention and antibiotic therapy, is crucial for maximizing clinical cure.
  • Early consideration of C. kroppenstedtii is vital, particularly in recurrent or severe cases of mastitis and abscess.

Implications:

  • Alerting microbiologists to the specific needs for C. kroppenstedtii culture and susceptibility testing is essential.
  • Clinicians should adopt a comprehensive strategy to manage C. kroppenstedtii infections effectively.
  • Further research is needed to establish definitive surgical and antibiotic treatment protocols, including optimal dosing and duration.

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