Osteomyelitis infection caused by Arcanobacterium haemolyticum in a diabetic patient: A first case report

Abstract

Arcanobacterium haemolyticum can cause deep infections, including osteomyelitis. In this study, an automated system misidentified this causal agent as Cellulomonas species but 16 s rRNA sequencing correctly identified it as A. haemolyticum. Recognizing the capability of A. haemolyticum to establish the disease is of great importance to enable accurate diagnosis and begin the suitable antibiotic therapy. Here we present the first case of successfully treated A. haemolyticum infective osteomyelitis in a 64-year-old Saudi patient with diabetes mellitus type 2 and review the characteristics of this seldom pathogenic agent.

Keywords: 16s rRNA; AMR, anti microbial resistance; AQ20, alignment quality; Arcanobacterium haemolyticum; CARD, the comprehensive antibiotic resistance database; CDS, coding sequence; Cellulitis; Diabetic foot ulcer; EUCAST, The European Committee on Antimicrobial Susceptibility Testing; ISPs, ion sphere particles; Ion PGM, ion personal genome machine; MUSCLE, multiple sequence comparison by log- expectation; NCBI, National Center for Biotechnology Information; NDARO, national database of antibiotic resistant organisms; Osteomyelitis; PATRIC, the Pathosystems Resource Integration Center; Q20, base call quality; RASTtk, rapid annotation using subsystem technology tool kit; RAxML, randomized axelerated maximum likelihood; Whole-genome sequencing and annotation.

Fig. 1

Patient information starting with the case report to the clinic until the complete recovery.

Fig. 2

(a) The distribution of the SCDR1 genome indicates a circular graphical display that includes CDS on the forward and reverse strand, RNA genes, CDS with homology to known antimicrobial resistance genes (AMR), and virulence factors. (b) phylogenetic analysis by selecting the closest reference and representative genomes of the PATRIC global protein families. Finally, we concatenated multiple alignments and phylogenic tree construction using MUSCLE and RaxML with fast bootstrapping.