Inflammatory granulomatous mastitis caused by Corynebacterium kroppenstedtii: A clinical challenge: Challenge of C. kroppenstedtii induced mastitis. (July 2022)

• Record Type: Journal Article
• Authors: Brouwer de Koning, I.M.; Lemson, A.; Renders, N.H.M.; Bessems, M.; Nooijen, P.T.G.A.; Draaisma, W.A.; Bosscha, K.
• Is Part Of: Clinical infection in practice. Volume 15(2022)
• Publication Date: 2022-07
• Subjects: Mastitis -- Corynebacterium -- Diagnostic techniques and procedures -- Antibacterial agent; Communicable diseases -- Periodicals; Infection -- Periodicals; Communicable Diseases; Infections; Communicable diseases; Infection; Electronic journals; Periodical; Electronic journals; Periodicals; 616.905
• DOI: 10.1016/j.clinpr.2022.100147
• Languages: English
• ISSNs: 2590-1702

Abstract

Highlights: It is important to rule out a malignancy as soon as possible in case of mastitis. The diagnostic process of Corynebacterium kroppenstedtii is a real challenge. Anaerobe culturing should be added to the standard diagnostic procedure in mastitis. Abstract: Background: Corynebacterium induced granulomatous mastitis is a rare inflammatory condition of the breast, generally occurring in parous reproductive-aged women, that could simulate inflammatory breast cancer. Therefore, it is important to rule out the diagnosis of cancer because treatment consists of long-term antibiotics or, in case of clinical deterioration, surgical procedures. However, excluding a malignancy and determining a Corynebacterium induced mastitis is a diagnostic challenge. Case report: Three patients with mastitis caused by Corynebacterium kroppenstedtii were described: a patient with a unilateral painful mass with abscess formation later, a patient with recurrent mastitis for months with a sudden progression and a patient with persisting mastitis despite antibiotic treatment. Results: Preoperative imaging reduced the possibility of, but was unable to exclude, a malignancy. Multiple and/or deep biopsies were needed to confirm granulomatous mastitis and extensive staining was needed to find Corynebacterium kroppenstedtii . Conclusion: Because clinical and/or radiological features are insufficient to prove Corynebacterium induced granulomatous mastitis, core-needle or surgical biopsies remain the cornerstone of the diagnosis together with extensive (beyond Gram) staining looking for Corynebacterium subspecies.