THE ROLE OF ARCANOBACTERIUM HAEMOLYTICUM IN THE DEVELOPMENT OF A PURULENT-NECROTIC LESION: A CLINICAL AND MICROBIOLOGICAL CASE REPORT

Abstract

Arcanobacterium haemolyticum is an under-recognised opportunistic pathogen that may contribute to skin and soft-tissue infections, particularly in patients with malignancy, tissue necrosis, impaired local blood supply, and immune dysfunction. This clinical and microbiological case report aimed to determine the significance of A. haemolyticum isolated from a purulent-necrotic lesion in a patient with recurrent basal cell carcinoma of the anterior chest wall. A male patient born in 1948 presented with an extensive malignant wound following repeated surgical interventions and radiotherapy, accompanied by sternal osteomyelitis, a pathological fracture, cachexia, and severe functional impairment. Bacteriological examination of an intraoperatively collected specimen from the deep area of the lesion yielded A. haemolyticum at a concentration of 10⁵ CFU/mL, and species identification was confirmed by MALDI-TOF mass spectrometry. The clinically significant microbial load and pronounced local signs of infection suggest that the isolate was not merely a surface coloniser but a potential aetiological agent contributing to the persistence of the inflammatory and necrotic process. This case highlights the importance of species-level identification and quantitative assessment of coryneform bacteria isolated from chronic malignant wounds to support individualised management of oncology and palliative care patients. Keywords: Arcanobacterium haemolyticum; basal cell carcinoma; malignant wound; purulent-necrotic lesion; skin and soft-tissue infection; opportunistic infection; palliative care.