Indiana University Infectious Diseases Fellowship
7 Feb,
9 tweets, 5 min read
#IdBoardReview 30 F (non-breast feeding)from Mexico 🇲🇽 w/ tender, erythematous, warm swelling of her breast. US +multiloculated abscess. She had intermittent episodes in past few months. Diagnosis? #idmedEd #medEd #IDtwitter 
C. #kroppenstedtii 1st in 2002 retrospective case series of granulomatous lobar mastitis in predominantly young Polynesian women, accounted for >40% of isolates. lipophilic lacks cell envelope mycolic acids, explains tissue tropism for lipid-rich mammary glands
C. #kroppenstedtii typically affects young women of reproductive age, challenging dx due to few organisms in clinical specimens, poor Gram stain & fastidious growth in culture on routine media
An accurate timely dx is important because empirical tx regimens are often ineffective, as many antibiotics are hydrophilic and distribute poorly in lipid-rich environments, such as the breast. In addition, surgical intervention is required
Maldi-tof may help with dx jcm.asm.org/content/54/8/1…
#corynebacterium #mastitis surgical drainage+abx doxy, tmp-smx, linezolid may be used but Antimicrobial susceptibility testing is essential due to resistance. 4 wks abx are advised
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