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Correspondence |

Fatal Kytococcus schroeteri Infection With Crusted Papules and Distinctive Histologic Plump Tetrads

Arielle R. Nagler, BS; Karolyn A. Wanat, MD; Michael A. Bachman, MD; David Elder, MB, ChB; Paul H. Edelstein, MD; Mindy G. Schuster, MD; Misha Rosenbach, MD
Arch Dermatol. 2011;147(9):1121-1122. doi:10.1001/archdermatol.2011.242.
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Correspondence: Dr Rosenbach, Department of Dermatology, University of Pennsylvania, 3600 Spruce St, Second Floor, Maloney Bldg, Philadelphia, PA 19104-4283 (misha.rosenbach@uphs.upenn.edu).

Financial Disclosure: None reported.

Becker K, Schumann P, W üllenweber J,  et al. Kytococcus schroeteri sp nov, a novel gram-positive actinobacterium isolated from a human clinical source. Int J Syst Evol Microbiol. 2002;52(pt 5):1609-1614
PubMed   |  Link to Article[[XSLOpenURL/10.1099/ijs.0.02069-0]]
Levenga H, Donnelly P, Blijlevens N, Verweij P, Shirango H, de Pauw B.Fatal hemorrhagic pneumonia caused by infection due to Kytococcus sedentarius: a pathogen or passenger? Ann Hematol. 2004;83(7):447-449
PubMed   |  Link to Article[[XSLOpenURL/10.1007/s00277-003-0831-x]]
Becker K, W üllenweber J, Odenthal HJ,  et al. Prosthetic valve endocarditis due to Kytococcus schroeteri. Emerg Infect Dis. 2003;9(11):1493-1495
Hodiamont CJ, Huisman C, Spanjaard L, van Ketel RJ.Kytococcus schroeteri pneumonia in two patients with a hematological malignancy. Infection. 2010;38(2):138-140
PubMed   |  Link to Article[[XSLOpenURL/10.1007/s15010-009-9295-4]]
Smith KJ, Neafie R, Yeager J, Skelton HG.Micrococcus folliculitis in HIV-1 disease. Br J Dermatol. 1999;141(3):558-561
PubMed   |  Link to Article[[XSLOpenURL/10.1046/j.1365-2133.1999.03060.x]]
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Figure 1. Right groin erythematous to violaceous papule with central crusting. Similar, smaller lesions were present in the left groin (not shown).

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Figure 2. Hematoxylin-eosin –(A-C) and gram-stained (D) biopsy specimens. A, Low-power histologic examination demonstrated an acanthotic epidermis with parakeratosis and numerous large cocci, many grouped in tetrads (original magnification ×4). B, Higher magnification demonstrating clumps of large cocci infiltrating the dermis (original magnification ×40). C, Highest magnification revealing the plump tetrads characteristic of Kytococcus schroeteri (original magnification ×100). D, High magnification of bronchoalveolar lavage specimen revealing tetrads of large gram-positive cocci with identical morphologic features (original magnification ×100).




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