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Choi, Kim, Choi, Cho, and Lee: A Case of Diabetic Foot Ulcer Caused by Arcanobacterium haemolyticum and Streptococcus agalactiae
Case Report
Korean Journal of Clinical Microbiology

Korean Journal of Clinical Microbiology 2012; 15(4): 143-146.

Published online: 21 December 2012

DOI: https://doi.org/10.5145/KJCM.2012.15.4.143

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

Moon Suk Choi1, Dal Sik Kim1, 2, Sam Im Choi1, 2, Yong Gon Cho1, 2, 3, Hye Soo Lee1, 2, 3

1Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Korea.

2Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.

3Chonbuk National University Hospital Culture Collection for Pathogens, Jeonju, Korea.

Correspondence: Hye Soo Lee, Department of Laboratory Medicine, Chonbuk National University Medical School, 634-18, Geumam-dong, Dukjin-gu, Jeonju 561-712, Korea. (Tel) 82-63-250-1218, (Fax) 82-63-250-1200, leehs@jbnu.ac.kr

Received 10 August 2012       Revised 26 September 2012       Accepted 18 October 2012

Copyright © 2012 The Korean Society of Clinical Microbiology

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.

Keywords: Arcanobacterium haemolyticum, Diabetic foot ulcer, Streptococcus agalactiae

Figures and Tables

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).
kjcm-15-143-g002
Fig. 3
CAMP inhibition reaction positive A. haemolyticum (white arrow) compared to CAMP reaction positive S. agalactiae on blood agar plate.
kjcm-15-143-g003

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