Division of Infectious Diseases

Case of the Month - November 2017

A 35 year old woman with a history of breast abscesses went to the Emergency Room for several days of right breast pain, itching, and a rash.  She noted that the breast pain had started several days after she began taking clindamycin for a dental abscess.   

 
On physical exam, her right breast was warm, tender, erythematous, and swollen.

An incision and drainage was performed and a bacteriology culture was sent.  The Gram stain revealed 4+ white blood cells, 3+ Gram-positive cocci in pairs and clusters, and 1+ Gram-positive branching bacilli.  After 48 hours of incubation, many pinpoint, white, non-hemolytic colonies were observed on blood agar, chocolate, and colistin-nalidixic plates.  This same bacterial species had grown from drainage from a left breast abscess in 2016.  Since MALDI has been used, this species has been increasingly identified in wound and blood cultures.

What is this aerotolerant, Gram-positive bacilli that can cause clinically significant skin infections?
   

 
Send answers to Dr. Ira Leviton, ileviton@montefiore.org. 

Figure 1 - Gram stain of abscess with many white blood cells, Gram-positive cocci, and Gram-positive bacilli  

Nov 21017-a
 
Figure 2 - Growth of non-hemolytic pinpoint colonies aerobically 

Nov 21017-b  

 

 

 

ASP News

Antimicrobial Stewardship Program Designated as Center of Excellence by IDSA
The Antimicrobial Stewardship Program (ASP) at Montefiore, led by medical director Priya Nori, MD, has been designated as a Center for Excellence by The Infectious Diseases Society of America (IDSA). It is among 25 academic sites in the nation – and one of few in New York City, to receive this prestigious recognition, which was announced on August 15, 2018.

 

Conferences & Seminars

Infectious Diseases Grand Rounds at Montefiore
Visiting Professor
Dr. Cindy Sears Professor of Medicine, Oncology and Molecular Microbiology and Immunology Johns Hopkins University School of Medicine Bloomberg-Kimmel Institute for Immunotherapy
Wednesday, October 24, 2018 @ 9:00 AM

Conference & Seminar Schedules

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