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Volume 29, Number 8—August 2023
CME ACTIVITY - Synopsis

Clinical Characteristics of Corynebacterium ulcerans Infection, Japan

Akihiko YamamotoComments to Author , Toru Hifumi, Manabu Ato, Masaaki Iwaki, Mitsutoshi Senoh, Akio Hatanaka, Shinichi Nureki, Yoshihiro Noguchi, Tomoko Hirose, Yukihiro Yoshimura, Takaaki Urakawa, Shiro Hori, Hiroto Nakada, Tomomasa Terada, Tomoko Ishifuji, Hisayo Matsuyama, Takahiro Kinebuchi, Atsuhito Fukushima, Koji Wake, Ken Otsuji, Takeru Endo, Hirokazu Toyoshima, Ikkoh Yasuda, Takeshi Tanaka, Naoki Takahashi, Kensaku Okada, Toshimasa Hayashi, Taizo Kusano, Minami Koriyama, Norio Otani, and Motohide Takahashi
Author affiliations: National Institute of Infectious Diseases, Tokyo, Japan (A. Yamamoto, M. Ato, M. Iwaki, M. Senoh); St. Luke’s International Hospital, Tokyo (T. Hifumi, N. Otani); Ageo Central Genral Hospital, Saitama, Japan (A. Hatanaka); Oita University Faculty of Medicine, Oita, Japan (S. Nureki); International University of Health and Welfare School of Medicine, Chiba, Japan (Y. Noguchi); Japanese Red Cross Otsu Hospital, Shiga, Japan (T. Hirose); Yokohama Municipal Citizen’s Hospital, Kanagawa, Japan (Y. Yoshimura); Tsuruoka Municipal Shonai Hospital, Yamagata, Japan (T. Urakawa); Japan Community Healthcare Organization Ritsurin Hospital, Kagawa, Japan (S. Hori); Holon Toriizaka Clinic, Tokyo (H. Nakada); Tokushima Prefectural Central Hospital, Tokushima, Japan (T. Terada); Itabashi Medical System Tokyo–Katsushika General Hospital, Katsushika, Tokyo (T. Ishifuji); Kawakita General Hospital, Suginami, Tokyo (H. Matsuyama); Furano Hospital, Hokkaido, Japan (T. Kinebuchi); Dokkyo Medical University, Tochigi, Japan (A. Fukushima, K. Wake); Hospital of University of Occupational and Environmental Health, Fukuoka, Japan (K. Otsuji, T. Endo); Japanese Red Cross Ise Hospital, Mie, Japan (H. Toyoshima); Fukushima Medical University, Fukushima, Japan (I. Yasuda); Nagasaki University Hospital, Nagasaki, Japan (T. Tanaka); Kimitsu Chuo Hospital, Chiba (N. Tanaka); Tottori University Hospital, Tottori, Japan (K. Okada); Maebashi Red Cross Hospital, Gunma, Japan (T. Hayashi); Chiba Children’s Hospital, Chiba (T. Kusano); Chiba Rousai Hospital, Chiba (M. Koriyama); Kumamoto Health Science University, Kumamoto, Japan (M. Takahashi)

Main Article

Table 1

Characteristics of patients with Corynebacterium ulcerans infection, Japan, 2001–2020*

Characteristic All cases, N = 34† Respiratory cases, n = 23‡ Nonrespiratory cases, n = 11§ p value
Median age, y
 58 (50–71)
 64 (54–72)
 38 (21–61)
 0.03
Sex
M 12 (38.7) 7 (31.8) 5 (55.6) 0.25
F
 19 (61.3)
 15 (68.2)
 4 (44.4)
 0.19
Relationship with animals¶
 33 (97.1)
 22 (95.7)
 11 (100)
 1.00
Vital signs on admission
Heart rate, beats/min 100 (88–112) 101 (97–114) 85 (85–85) 0.13
Systolic blood pressure, mm Hg 125 (107–146) 130 (108–147) 107 (107–107) 0.32
Body temperature, °C 38 (37.4–38.5) 38 (37.4–38.4) 38.4 (35.5–38.5) 0.94
Respiratory rate, breaths/min
 20 (16–26)
 18 (16–28)
 21 (21–21)
 0.61
Laboratory data
Leukocytes, cells/mm3 13,800 (9,325–18,900) 14,800 (10,850–21,700) 10,500 (7,775–12,700) 0.07
Platelets, × 104/mm3 26.3 (22.1–27.2) 25.1 (19.9–34.1) 26.6 (26.3–26.8) 0.51
Creatine, mg/dL 0.75 (0.66–1.16) 0.75 (0.67–1.24) 0.59 (0.38–0.80) 0.34
C-reactive protein, mg/dL
 6.1 (3.7–16.8)
 10.8 (4.7–21)
 3.9 (2.3–5.7)
 0.07
Treatment antibiotic (no. cases)
Penicillins Penicillin G (2), sulbactam/ampicillin (9), piperacillin (5) Penicillin G (1), sulbactam/ampicillin (8), piperacillin (4) Penicillin G (1), sulbactam/ampicillin (1), piperacillin (1)
Macrolides Erythromycin (9), clarithromycin (6), azithromycin (6), clindamycin (1) Erythromycin (6), clarithromycin (5), azithromycin (5), clindamycin (1) Erythromycin (3), azithromycin (1), clarithromycin (1)
Cephalosporins Cephepime (1), cefazolin (1), ceftriaxone (1) Cephepime (1), ceftriaxone (1) Cefazolin (1)
Quinolones Levofloxacin (3) Levofloxacin (2) Levofloxacin (1)
Other
 Meropenem (3), faropenem (1), minocycline (1)
 Meropenem (3)
 Faropenem (1), minocycline (1)
Diphtheria antitoxin
 4 (11.8)
 4 (17.4)
 0
 0.28
Classification of respiratory symptoms
Mild 8 6 2
Moderate 16 7 9
Severe
 10
 10
 0
Outcome
Hospital days 10 (3–30) 13 (4–31) 9 (0–26) 0.41
Ventilator days 0 (0–6) 2 (0–12) 0 0.04
Deaths# 2 (5.9) 2 (8.7) 0 1.00

*Data are medians (interquartile range) for continuous variables and no. (%) for categorical variables. †Missing data for all cases: age (n = 3), sex (n = 3), heart rate (n = 27), systolic blood pressure (n = 27), body temperature (n = 19), respiratory rate (n = 27), leukocytes (n = 17), platelets (n = 26), creatine (n = 23), C-reactive protein (n = 17), treatment (n = 10), hospital days (n = 8), ventilator days (n = 9). ‡Missing data for respiratory cases: age (n = 1), sex (n = 1), heart rate (n = 17), systolic blood pressure (n = 17), body temperature (n = 11), respiratory rate (n = 17), pseudomembrane (n = 1), leukocyte (n = 10), platelets (n = 17), T-bilirubin (n = 17), creatine (n = 14), C-reactive protein (n = 10), treatment (n = 5), hospital days (n = 3), ventilator days (n = 4). §Missing data for nonrespiratory cases: age (n = 2), sex (n = 2), heart rate (n = 10), systolic blood pressure (n = 10), body temperature (n = 8), respiratory rate (n = 10), leukocytes (n = 7), platelets (n = 10), T-bilirubin (n = 11), creatine (n = 9), C-reactive protein (n = 7), treatment (n = 5), hospital days (n = 5), ventilator days (n = 5). ¶Indicates the presence of animals in the patient’s living environment. #All deaths were in cases for which respiratory symptoms were classified as severe.

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Page created: May 31, 2023
Page updated: July 20, 2023
Page reviewed: July 20, 2023
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