A case of cutaneous toxigenic Corynebacterium ulcerans likely acquired from a domestic dog

Richard Othieno*, Kate Mark, Michelle Etherson, G Foster, Steven Murray, Pota Kalima, Norman Fry, Claire Cameron, Jenni Strachan

*Corresponding author for this work

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Abstract

Introduction. Corynebacterium ulcerans can produce diphtheria toxin and although still rare, is now the predominant cause of toxigenic diphtheria infection in the UK, making this organism of great clinical and public health importance. Here we describe a cutaneous case, likely secondary to domestic animal contact.
Case presentation. A 60-year-old female presented with a slow-healing finger-burn wound. A skin swab cultured Corynebacterium ulcerans, which was confirmed to be toxin producing. She resided with her partner and two dogs, one of which had a chronic skin lesion. Her most recent diphtheria vaccine was in 2009. Four close contacts were identified, two of whom were healthcare professionals, and nose and throat swabs were obtained. The patient was treated with clarithromycin (14 day course), diphtheria vaccine and excluded from work until completion of antibiotics and negative clearance swabs. Contacts were given erythromycin (7 day course), vaccinated and healthcare worker contacts excluded from work until swab negative. A veterinary practitioner swabbed the throats and a skin lesion of their dogs. One contact (partner of patient) and all dog swabs were positive. Partial allelic profiles from MLST supported an epidemiological link. The dogs were treated with antibiotics and antimicrobial skin wash. Repeat swabs for the index case, contact and both dogs were negative following treatment.
Conclusion. This was a rare case of cutaneous diphtheria secondary to Corynebacterium ulcerans with domestic animals the most likely source, although human-to-human contact could not be excluded, with important human and animal public health implications.
Original languageEnglish
Number of pages5
JournalAccess Microbiology
Early online date30 May 2019
DOIs
Publication statusPrint publication - 3 Jun 2019

Fingerprint

Corynebacterium
Dogs
Skin
Diphtheria Toxoid
Diphtheria
Domestic Animals
Pharynx
Public Health
Anti-Bacterial Agents
Delivery of Health Care
Diphtheria Toxin
Clarithromycin
Erythromycin
Burns
Nose
Fingers
Wounds and Injuries
Infection

Keywords

  • Corynebacterium
  • Wound infection
  • Public health
  • Vaccination
  • Zoonoses

Cite this

Othieno, Richard ; Mark, Kate ; Etherson, Michelle ; Foster, G ; Murray, Steven ; Kalima, Pota ; Fry, Norman ; Cameron, Claire ; Strachan, Jenni . / A case of cutaneous toxigenic Corynebacterium ulcerans likely acquired from a domestic dog. In: Access Microbiology. 2019.
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abstract = "Introduction. Corynebacterium ulcerans can produce diphtheria toxin and although still rare, is now the predominant cause of toxigenic diphtheria infection in the UK, making this organism of great clinical and public health importance. Here we describe a cutaneous case, likely secondary to domestic animal contact.Case presentation. A 60-year-old female presented with a slow-healing finger-burn wound. A skin swab cultured Corynebacterium ulcerans, which was confirmed to be toxin producing. She resided with her partner and two dogs, one of which had a chronic skin lesion. Her most recent diphtheria vaccine was in 2009. Four close contacts were identified, two of whom were healthcare professionals, and nose and throat swabs were obtained. The patient was treated with clarithromycin (14 day course), diphtheria vaccine and excluded from work until completion of antibiotics and negative clearance swabs. Contacts were given erythromycin (7 day course), vaccinated and healthcare worker contacts excluded from work until swab negative. A veterinary practitioner swabbed the throats and a skin lesion of their dogs. One contact (partner of patient) and all dog swabs were positive. Partial allelic profiles from MLST supported an epidemiological link. The dogs were treated with antibiotics and antimicrobial skin wash. Repeat swabs for the index case, contact and both dogs were negative following treatment.Conclusion. This was a rare case of cutaneous diphtheria secondary to Corynebacterium ulcerans with domestic animals the most likely source, although human-to-human contact could not be excluded, with important human and animal public health implications.",
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A case of cutaneous toxigenic Corynebacterium ulcerans likely acquired from a domestic dog. / Othieno, Richard; Mark, Kate; Etherson, Michelle; Foster, G; Murray, Steven; Kalima, Pota; Fry, Norman ; Cameron, Claire; Strachan, Jenni .

In: Access Microbiology, 03.06.2019.

Research output: Contribution to journalArticle

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T1 - A case of cutaneous toxigenic Corynebacterium ulcerans likely acquired from a domestic dog

AU - Othieno, Richard

AU - Mark, Kate

AU - Etherson, Michelle

AU - Foster, G

AU - Murray, Steven

AU - Kalima, Pota

AU - Fry, Norman

AU - Cameron, Claire

AU - Strachan, Jenni

PY - 2019/6/3

Y1 - 2019/6/3

N2 - Introduction. Corynebacterium ulcerans can produce diphtheria toxin and although still rare, is now the predominant cause of toxigenic diphtheria infection in the UK, making this organism of great clinical and public health importance. Here we describe a cutaneous case, likely secondary to domestic animal contact.Case presentation. A 60-year-old female presented with a slow-healing finger-burn wound. A skin swab cultured Corynebacterium ulcerans, which was confirmed to be toxin producing. She resided with her partner and two dogs, one of which had a chronic skin lesion. Her most recent diphtheria vaccine was in 2009. Four close contacts were identified, two of whom were healthcare professionals, and nose and throat swabs were obtained. The patient was treated with clarithromycin (14 day course), diphtheria vaccine and excluded from work until completion of antibiotics and negative clearance swabs. Contacts were given erythromycin (7 day course), vaccinated and healthcare worker contacts excluded from work until swab negative. A veterinary practitioner swabbed the throats and a skin lesion of their dogs. One contact (partner of patient) and all dog swabs were positive. Partial allelic profiles from MLST supported an epidemiological link. The dogs were treated with antibiotics and antimicrobial skin wash. Repeat swabs for the index case, contact and both dogs were negative following treatment.Conclusion. This was a rare case of cutaneous diphtheria secondary to Corynebacterium ulcerans with domestic animals the most likely source, although human-to-human contact could not be excluded, with important human and animal public health implications.

AB - Introduction. Corynebacterium ulcerans can produce diphtheria toxin and although still rare, is now the predominant cause of toxigenic diphtheria infection in the UK, making this organism of great clinical and public health importance. Here we describe a cutaneous case, likely secondary to domestic animal contact.Case presentation. A 60-year-old female presented with a slow-healing finger-burn wound. A skin swab cultured Corynebacterium ulcerans, which was confirmed to be toxin producing. She resided with her partner and two dogs, one of which had a chronic skin lesion. Her most recent diphtheria vaccine was in 2009. Four close contacts were identified, two of whom were healthcare professionals, and nose and throat swabs were obtained. The patient was treated with clarithromycin (14 day course), diphtheria vaccine and excluded from work until completion of antibiotics and negative clearance swabs. Contacts were given erythromycin (7 day course), vaccinated and healthcare worker contacts excluded from work until swab negative. A veterinary practitioner swabbed the throats and a skin lesion of their dogs. One contact (partner of patient) and all dog swabs were positive. Partial allelic profiles from MLST supported an epidemiological link. The dogs were treated with antibiotics and antimicrobial skin wash. Repeat swabs for the index case, contact and both dogs were negative following treatment.Conclusion. This was a rare case of cutaneous diphtheria secondary to Corynebacterium ulcerans with domestic animals the most likely source, although human-to-human contact could not be excluded, with important human and animal public health implications.

KW - Corynebacterium

KW - Wound infection

KW - Public health

KW - Vaccination

KW - Zoonoses

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DO - 10.1099/acmi.0.000025

M3 - Article

JO - Access Microbiology

JF - Access Microbiology

ER -