Prepatellar Bursitis with Abscess due to Corynebacterium ulcerans

Area of Science:

• Infectious Diseases
• Microbiology
• Clinical Case Reports

Background:

• Corynebacteria, typically commensals, are increasingly recognized for their pathogenic potential in humans.
• Corynebacterium ulcerans infections are rising in Europe, presenting similar clinical syndromes to Corynebacterium diphtheriae.
• C. ulcerans causes diverse infections, including airway, skin, soft tissue, lymphadenitis, and wound infections, with zoonotic transmission from animals.

Observation:

• A rural farmer presented with acute right knee pain and was diagnosed with prepatellar bursitis with abscess.
• The infection was caused by Corynebacterium ulcerans, identified through clinical diagnosis and likely zoonotic transmission.
• This represents the first documented case of C. ulcerans causing prepatellar bursitis with abscess in medical literature.

Findings:

• Corynebacterium ulcerans strains can be toxigenic or nontoxigenic, necessitating strain characterization.
• Antimicrobial susceptibility testing is crucial as C. ulcerans may exhibit resistance to standard antibiotic treatments.
• Mass spectrometry facilitates easier strain characterization, aiding in understanding virulence and treatment.

Implications:

• This case underscores the zoonotic potential of C. ulcerans and its capacity to cause unusual infections like prepatellar bursitis.
• Highlights the importance of considering C. ulcerans in differential diagnoses for soft tissue infections, especially in individuals with animal contact.
• Emphasizes the need for appropriate diagnostic methods, including antimicrobial susceptibility testing and potentially toxin analysis, for effective management of C. ulcerans infections.