Detection of specific cellular immune response to Bartonella henselae in a patient with cat scratch disease.

hemoglobin level, hematocrit, platelet count, and results of blood sis, Corynebacterium pyogenes, Corynebacterium haemolyticum, Corynebacterium kutscheri, Corynebacterium group D2, and two nonchemistry and urinalysis were all within normal limits, and cultures of blood were negative. speciated corynebacteria. With the exception of the most resistant strains, C. jeikeium and Empiric antimicrobial therapy was initiated with iv vancomycin, 1,000 mg every 12 hours, and iv aztreonam, 2 g every 8 hours. The Corynebacterium urealyticum, most Corynebacterium species are susceptible to penicillin, ampicillin, cephalosporins, aminoglycopatient was afebrile within 24 hours of the incision-and-drainage procedure and aztreonam was subsequently discontinued. On the sides, vancomycin, rifampin, and the fluoroquinolones. 10th day of antimicrobial therapy, a febrile reaction to vancomycin prompted a change in therapy to ciprofloxacin, 750 mg every 12 Lawrence A. Cone, Noel Curry, Moxelle A. Wuestoff, hours, for an additional week. Within another 3 weeks, the patient Stephen J. O’Connell, and John F. Feller had returned to his full-time gastroenterology practice. A followDepartments of Medicine, Orthopedic Surgery, Pathology, and up MRI scan confirmed resolution of the septic synovitis. Radiology, Eisenhower Medical Center, Rancho Mirage, California C. striatum is a nonsporulating, non-acid-fast, pleomorphic, gram-positive rod that is aerobic and facultatively anaerobic. The References organism appears striated on gram-stained preparations. Excluding 1. Watkins DA, Chahine A, Creger RJ, Jacobs MR, Lazarus HM. Corynebactethe case we describe, only 22 cases of infection due to C. striatum rium striatum: a diphtheroid with pathogenic potential. Clin Infect Dis have been reported. 1993;17:21–5. The organism is normally found in the nose, mucous membranes, 2. Rufael DW, Cohn SE. Native valve endocarditis due to Corynebacterium and the skin of the arms, forehead, and cheeks, and is isolated most striatum: case report and review. Clin Infect Dis 1994;19:1054–61. often from the upper half of the body. Corynebacterium jeikeium in 3. Weiss K, Labbe AC, Laverdiere M. Corynebacterium striatum meningitis: contrast, colonizes the axillary, inguinal, and anal areas of the skin. case report and review of an increasingly important Corynebacterium Men are predisposed to bacteremia due to Corynebacterium species, species. Clin Infect Dis 1996;23:1246–48. probably because the sebum content of their skin is higher than that 4. National Committee for Clinical Laboratory Standards. Susceptibility testof women, and thus provides more fat and fatty acids for growth of ing criteria and QC parameters: approved guidelines. NCCLS document lipophilic diphtheroids. Previous reports of septic arthritis caused by M23A. Wayne, Pennsylvania: National Committee for Clinical Laboratory Standards, 1995. other corynebacteria included infections due to Corynebacterium xero-