Chorioamnionitis and funisitis due to Corynebacterium kutscheri

Abstract

SUMMARY When isolated from the female genital tract, diphtheroids are usually regarded as commensal organisms. Corynebacterium kutscheri however is a pathogen in laboratory rodents. We report a case in which C. kutscheri was isolated as a pure culture from the umbilical cord and from other surface sites in an infant. Histological examination of the cord and membranes demonstrated the organisms within these fetal tissues. The organisms evoked a fetal cellular response. The impor-tance of recognising commensals as potential pathogens in states of altered host resistance is stressed. Chorioamnionitis (inflammation of fetal membranes and the fetal surface of the placenta) and funisitis (inflammation of the umbilical cord) are often caused by ascending infections from the lower genital tract, and organisms that are regarded as normal commensals in this area are generally responsible. Although diphtheroids are part of the normal flora of the genital tract (Leppaluoto, 1974; Galask et al., 1976) and have been isolated from the placental fetal surface and the fetal membranes (Benirschke and Driscoll, 1967), their pathogenicity is uncertain. As Benirschke and Driscoll (1967) stated, 'Results of cultures per se, were inconclusive. Doubtless this was because most of the placentas had traversed the lower genital tract prior to examination, and because the cultures were then taken from the exposed amniotic surface. However, taken in conjunction with other data, bacteriological cultures become very useful'. It is worth re-emphasising that an 'infection ' is usually defined as the invasion and multiplication of an organism within living tissues of the host (Walter and Israel, 1974). This report describes what we believe may be the first case of infection of the fetal membranes and cord in an infant due to a Coryne-bacterium species. Case report A baby girl was born prematurely at 26 weeks' gestation to a 42-year-old grand multiparou