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Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition) ›› 2023, Vol. 17 ›› Issue (01): 55-59. doi: 10.3877/cma.j.issn.1674-1358.2023.01.009

Special Issue:

• Case Report • Previous Articles     Next Articles

A case of granulomatous mastitis complicated with erythema nodosum of the lower extremities caused by Corynebacterium tuberculosis and literatures review

Shouhao Wang1, Hanzhu Chen1, Tianshi Ma2, Yongxi Tong1, Zhewen Zhou1, Chengan Xu1, Xingdi Yang1, Wenya Ren1, Hongying Pan1,()   

  1. 1. Department of Infectious Diseases, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
    2. Department of Pathology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
  • Received:2022-06-24 Online:2023-02-15 Published:2023-04-26
  • Contact: Hongying Pan

Abstract:

Objective

To investigate the diagnosis and treatment of granulomatous mastitis with erythema nodosum in lower limbs caused by Corynebacterium tuberculosis.

Methods

The diagnosis and treatment process of a patient with granulomatous mastitis caused by Corynebacterium tuberculosis complicated with erythema nodosum in lower limbs admitted to Zhejiang Provincial People’s Hospital on March 28th, 2022 was analyzed and related literatures were reviewed.

Results

This case was a 30-year-old young female patient who was admitted to Zhejiang Provincial People’s Hospital for a half-month period of pain due to the left breast mass. The oral cefuroxime axetil had poor anti-infective treatment effect. The diagnosis was confirmed by histopathology, puncture fluid culture and 16S rRNA sequence analysis as granulomatous mastitis caused by Corynebacterium tuberculosis with erythema nodosum in lower limbs. The results of drug sensitivity test showed that vancomycin and linezolid were sensitive. Subsequently, abscess incision and drainage combined with drug treatment (linezolid and prednisone) were performed, and the mass reduced significantly and the inflammation improved, and the patient was discharged.

Conclusions

Granulomatous mastitis complicated with erythema nodosum of lower limbs caused by Corynebacterium tuberculosis infection is rare, which is easy to be misdiagnosed and mistreated. Bacterial/fungal culture, 16S rRNA sequence analysis and drug sensitivity test should be combined to identify the pathogenic bacteria and carry out targeted anti-infective treatment.

Key words: Corynebacterium tuberculosis, Granulomatous mastitis, Erythema nodosum

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