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C. kroppenstedtii-related mastitis potentially linked to psychiatric illness
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At least one-third of patients with Corynebacterium kroppenstedtii mastitis experienced psychiatric illness in a recent study. Researchers suspect that drug-induced hyperprolactinemia may play a role, but said further research is needed.
“C. kroppenstedtii is a lipophilic Corynebacterium first described in 1998 after isolation from a sputum specimen,” Sally C. Y. Wong, MBBChair, FRCPath, from the Queen Mary Hospital in Hong Kong and the University of Hong Kong, and colleagues wrote. “Association with breast conditions, especially recurrent granulomatous mastitis, was noted subsequently. Occasional reports of bacteremia, and a single report of prosthetic valve infection have also been described. However, knowledge on risk factors associated with C. kroppenstedtii, clinical presentations and significant remained incomplete.”
Researchers retrospectively analyzed the clinical, microbiological and investigative findings from 42 patients, 39 of whom were female, with C. kroppenstedtii isolated from clinical specimens between January 2009 and January 2015 in Hong Kong.
They isolated 46 strains of C. kroppenstedtii, including 41 breast-related samples and five non–breast-related specimens. The results showed that the predominance of breast-related specimens (89%) was consistent with previous reports of the bacterium’s potential association with mastitis and abscesses.
Wong and colleagues observed psychiatric illness in 37% of patients with C. kroppenstedtii-related mastitis/abscesses — significantly higher than the local prevalence of 8.97% in the female population with mixed anxiety and depressive disorders, and 2.5% of psychotic disorders in Hong Kong. More than 92% of these patients received antipsychotic medications.
Based on their results, the researchers suggested that antipsychotic-induced hyperprolactinemia may be the reason for the potential association between C. kroppenstedtii and psychiatric illness, although other potential contributing factors, including behavior and personal hygiene, cannot be excluded.
Patients with C. kroppenstedtii also had a higher risk of recurrence of mastitis/abscesses. Granulomatous inflammation was observed more frequently in patients with prolonged symptoms, suggesting a common etiology between nongranulomatous and granulomatous mastitis.
To establish the exact role of hyperprolactinemia in C. kroppenstedtii-related mastitis/abscesses, Wong and colleagues recommended routinely checking serum prolactin levels to identify patients who may benefit from withdrawal of prolactin-inducing drugs. – by Savannah Demko
Disclosure: The researchers report no relevant financial disclosures.
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