Korean J Clin Microbiol.  2012 Dec;15(4):143-146. 10.5145/KJCM.2012.15.4.143.

A Case of Diabetic Foot Ulcer Caused by Arcanobacterium haemolyticum and Streptococcus agalactiae

• Choi MS
• Kim DS
• Choi SI
• Cho YG
• Lee HS

• KMID: 1431811
• DOI: http://doi.org/10.5145/KJCM.2012.15.4.143

Abstract

Arcanobacterium haemolyticum, a aerobic Gram-positive rod, has been described as an unusual pathogen causing soft tissue infections such as pharyngotonsillitis, chronic ulcer and cellulitis. In addition, the microorganism causes deep-seated infection and systemic disease including endocarditis, vertebral osteomyelitis and sepsis in patients with predisposing conditions such as diabetes mellitus. Since colonies and microscopic findings of A. haemolyticum might be confused with those of streptococci and coryneform bacteria, and it is usually isolated with other microorganisms, it is often considered to be normal flora or a contaminant in wound infections, resulting in missed or delayed diagnosis. Streptococcus agalactiae infections in neonates and pregnant women have been well recognized. However, invasive S. agalactiae infections in non-pregnant older adults with chronic medical conditions, particularly diabetes mellitus, are increasing. We report a case of diabetic foot ulcer due to A. haemolyticum and S. agalactiae in an uncontrolled diabetes mellitus patient.

Keyword

Arcanobacterium haemolyticum; Diabetic foot ulcer; Streptococcus agalactiae

MeSH Terms

Adult
Arcanobacterium
Bacteria
Cellulitis
Delayed Diagnosis
Diabetes Mellitus
Diabetic Foot
Endocarditis
Female
Humans
Infant, Newborn
Osteomyelitis
Pregnant Women
Sepsis
Soft Tissue Infections
Streptococcus
Streptococcus agalactiae
Ulcer
Wound Infection

Figure

• 

  Fig. 1 Diabetic foot ulcer after debridement of necrotic tissue (Left foot).

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  Fig. 2 (A) Colony morphology of A. haemolyticum on blood agar plate. Tiny, gray-white colored colonies with β hemolysis are shown (35℃, 48 hrs). (B) Gram stain of A. haemolyticum shows gram positive polymorphic rod (×1,000).

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  Fig. 3 CAMP inhibition reaction positive A. haemolyticum (white arrow) compared to CAMP reaction positive S. agalactiae on blood agar plate.

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