Arcanobacterium haemolyticum

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Arcanobacterium haemolyticum
Arcanobacterium haemolyticum after 48 hours.jpg
Arcanobacterium haemolyticum colonies on a blood agar plate: Beta-hemolysis is demonstrated with transmitted light.
Scientific classification OOjs UI icon edit-ltr.svg
Domain: Bacteria
Phylum: Actinomycetota
Class: Actinomycetia
Order: Actinomycetales
Family: Actinomycetaceae
Genus: Arcanobacterium
Species:
A. haemolyticum
Binomial name
Arcanobacterium haemolyticum
(ex Mac Lean et al. 1946) Collins et al. 1983
Synonyms
  • Corynebacterium haemolyticumMacLean et al. 1946

Arcanobacterium haemolyticum is a species of bacteria classified as a gram-positive bacillus. It is catalase-negative, facultative anaerobic, beta-hemolytic, and not motile. [1] It has been known to cause head and neck infections, pharyngitis, and sinusitis (Arcanobacterium haemolyticum infections). [1]

Contents

History

It was first described by MacClean et al. in 1946 from US servicemen and peoples of the South Pacific suffering from sore throat. [2] Due to its resemblance to another genus of bacteria, Corynebacterium , A. haemolyticum was initially classified as C. pyogenes subspecies hominus. [3] It was known for several decades as Corynebacterium haemolyticum; controversies regarding classification were resolved in 1982 when a new genus, Arcanobacterium , was created by Collins et al. [4] [5] to reclassify Corynebacterium haemolyticum on the basis of its peptidoglycan, fatty acid, and DNA characteristics.

Since its initial description, the spectrum of diseases caused by A. haemolyticum has been expanded to include sepsis and osteomyelitis. [6] Organisms are Gram-positive, facultative anaerobic, catalase-negative rods (but transition to the coccal shape occurs as the organism grows) with arrangements described as matchbox or Chinese letters arrangements. Growth is enhanced in blood and by carbon dioxide.

Detection

Hemolysis is detected on human blood agar plates, and routine plating of specimens suspected of containing A. haemolyticum on human blood agar is suggested to distinguish it from Streptococcus pyogenes , as A. haemolyticum can easily be confused with this organism. Microscopic morphology differences can be used to differentiate them, since Arcanobacterium is rod-shaped and Streptococcus is coccus-shaped. [7]

A. haemolyticum infection is most common in 15- to 25-year-old persons and manifests as exudative pharyngitis and/or tonsillitis accompanied by cervical lymphadenopathy. Symptoms look like those of β-hemolytic streptococci or viral infection. A rash of the chest and of the abdomen, neck, or extremities is seen in 20% to 25% of cases, enhancing the risk of diagnostic error as streptococcal infection or penicillin allergy, when β-lactam therapy is initiated without exact diagnosis. [3]

A. haemolyticum often occurs in polymicrobic infections together with typical respiratory pathogens such as streptococci. The isolation of classical pathogens from specimens that also contain A. haemolyticum might be in part responsible for the tendency to miss the organism.

Pathology

A. haemolyticum is the cause of pharyngitis (sore throat) in up to 2.5% of cases. [8] In one study, it was the causative agent of pharyngitis in 1.4% of military conscripts. [9] It is rarely found in the skin or throat of healthy people, meaning it is not a member of the usual bacterial flora. [3]

Little is known about the means by which A. haemolyticum causes infection or the associated skin manifestations. The organism is known to produce uncharacterized hemolytic agent(s), a neuraminidase and a phospholipase D (PLD) acting preferentially on sphingomyelin. PLD is known to result in tissue damage, but the role in disease of the cytotoxic effect caused by this extracellular toxin is not established.

Pyothorax has been reported. [10]

Treatment

A. haemolyticum isolated from humans is susceptible to erythromycin [11] (proposed as the first-line drug), clindamycin, gentamicin, and cephalosporins.

The use of parenteral antimicrobial drugs must be limited to serious infections.

See also

Related Research Articles

<i>Streptococcus</i> Genus of bacteria

Streptococcus is a genus of gram-positive coccus or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales, in the phylum Bacillota. Cell division in streptococci occurs along a single axis, so as they grow, they tend to form pairs or chains that may appear bent or twisted. This differs from staphylococci, which divide along multiple axes, thereby generating irregular, grape-like clusters of cells. Most streptococci are oxidase-negative and catalase-negative, and many are facultative anaerobes.

<span class="mw-page-title-main">Group A streptococcal infection</span> Medical condition

Group A streptococcal infections are a number of infections with Streptococcus pyogenes, a group A streptococcus (GAS). S. pyogenes is a species of beta-hemolytic Gram-positive bacteria that is responsible for a wide range of infections that are mostly common and fairly mild. If the bacteria enter the bloodstream an infection can become severe and life-threatening, and is called an invasive GAS (iGAS).

<i>Streptococcus pyogenes</i> Species of bacterium

Streptococcus pyogenes is a species of Gram-positive, aerotolerant bacteria in the genus Streptococcus. These bacteria are extracellular, and made up of non-motile and non-sporing cocci that tend to link in chains. They are clinically important for humans, as they are an infrequent, but usually pathogenic, part of the skin microbiota that can cause Group A streptococcal infection. S. pyogenes is the predominant species harboring the Lancefield group A antigen, and is often called group A Streptococcus (GAS). However, both Streptococcus dysgalactiae and the Streptococcus anginosus group can possess group A antigen as well. Group A streptococci, when grown on blood agar, typically produce small (2–3 mm) zones of beta-hemolysis, a complete destruction of red blood cells. The name group A (beta-hemolytic) Streptococcus (GABHS) is thus also used.

<span class="mw-page-title-main">Scarlet fever</span> Infectious disease caused by Streptococcus pyogenes

Scarlet fever, also known as scarlatina, is an infectious disease caused by Streptococcus pyogenes, a Group A streptococcus (GAS). The infection is a type of Group A streptococcal infection. It most commonly affects children between five and 15 years of age. The signs and symptoms include a sore throat, fever, headache, swollen lymph nodes, and a characteristic rash. The face is flushed and the rash is red and blanching. It typically feels like sandpaper and the tongue may be red and bumpy. The rash occurs as a result of capillary damage by exotoxins produced by S.pyogenes. On darker-pigmented skin the rash may be hard to discern.

<span class="mw-page-title-main">Streptococcal pharyngitis</span> Medical condition

Streptococcal pharyngitis, also known as streptococcal sore throat, is pharyngitis caused by Streptococcus pyogenes, a gram-positive, group A streptococcus. Common symptoms include fever, sore throat, red tonsils, and enlarged lymph nodes in the front of the neck. A headache and nausea or vomiting may also occur. Some develop a sandpaper-like rash which is known as scarlet fever. Symptoms typically begin one to three days after exposure and last seven to ten days.

<span class="mw-page-title-main">Pharyngitis</span> Inflammation of the back of the throat

Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a hoarse voice. Symptoms usually last 3–5 days, but can be longer depending on cause. Complications can include sinusitis and acute otitis media. Pharyngitis is a type of upper respiratory tract infection.

<span class="mw-page-title-main">Upper respiratory tract infection</span> Medical condition

An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, larynx or trachea. This commonly includes nasal obstruction, sore throat, tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold. Most infections are viral in nature, and in other instances, the cause is bacterial. URTIs can also be fungal or helminthic in origin, but these are less common.

<span class="mw-page-title-main">Tonsillitis</span> Inflammation of the tonsils

Tonsillitis is inflammation of the tonsils in the upper part of the throat. It can be acute or chronic. Acute tonsillitis typically has a rapid onset. Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and enlarged lymph nodes around the neck. Complications include peritonsillar abscess (Quinsy).

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Streptococcus agalactiae is a gram-positive coccus with a tendency to form chains. It is a beta-hemolytic, catalase-negative, and facultative anaerobe.

<span class="mw-page-title-main">Lymphangitis</span> Medical condition

Lymphangitis is an inflammation or an infection of the lymphatic channels that occurs as a result of infection at a site distal to the channel. The most common cause of lymphangitis in humans is Streptococcus pyogenes, hemolytic streptococci, and in some cases, mononucleosis, cytomegalovirus, tuberculosis, syphilis, and the fungus Sporothrix schenckii. Lymphangitis is sometimes mistakenly called "blood poisoning". In reality, "blood poisoning" is synonymous with sepsis.

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Arcanobacterium is a genus of bacteria. They are gram-positive, non–acid fast, nonmotile, facultatively anaerobic, and non–endospore forming. They are widely distributed in nature in the microbiota of animals and are mostly innocuous. Some can cause disease in humans and other animals. As with various species of a microbiota, they usually are not pathogenic but can occasionally opportunistically capitalize on atypical access to tissues or weakened host defenses.

<i>Streptococcus canis</i> Species of bacterium

Streptococcus canis is a group G beta-hemolytic species of Streptococcus. It was first isolated in dogs, giving the bacterium its name. These bacteria are characteristically different from Streptococcus dysgalactiae, which is a human-specific group G species that has a different phenotypic chemical composition. S. canis is important to the skin and mucosal health of cats and dogs, but under certain circumstances, these bacteria can cause opportunistic infections. These infections were known to afflict dogs and cats prior to the formal description of the species in Devriese et al., 1986. However, additional studies revealed cases of infection in other mammal species, including cattle and even humans. Instances of mortality from S. canis in humans are very low with only a few reported cases, while actual instances of infection may be underreported due to mischaracterizations of the bacteria as S. dysgalactiae. This species, in general, is highly susceptible to antibiotics, and plans to develop a vaccine to prevent human infections are currently being considered.

<i>Streptococcus dysgalactiae</i> Species of bacterium

Streptococcus dysgalactiae is a gram positive, beta-haemolytic, coccal bacterium belonging to the family Streptococcaceae. It is capable of infecting both humans and animals, but is most frequently encountered as a commensal of the alimentary tract, genital tract, or less commonly, as a part of the skin flora. The clinical manifestations in human disease range from superficial skin-infections and tonsillitis, to severe necrotising fasciitis and bacteraemia. The incidence of invasive disease has been reported to be rising. Several different animal species are susceptible to infection by S. dysgalactiae, but bovine mastitis and infectious arthritis in lambs have been most frequently reported.

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References

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