{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:10:11Z","timestamp":1790683811892,"version":"4.1.0"},"reference-count":5,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin & Trans Imm"],"published-print":{"date-parts":[[2026,8]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n \n In this case, we present a patient with rapidly progressive unilateral destructive orbital and midface inflammation. Initial detection of\n Corynebacterium kroppenstedtii<\/jats:italic>\n was followed by a consistent course of localised necrotizing small\u2010vessel vasculitis, which was responsive to B\u2010cell depletion.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A 79\u2010year\u2010old woman presented with acute left periorbital pain, tearing and purulent discharge. The workup included serial microbiological cultures, fungal and mycobacterial testing, molecular diagnostics, CT\/MRI\/PET\u2010CT imaging, multiple surgical biopsies with histopathology and special stains, ANCA testing, and multidisciplinary treatments (antimicrobials, glucocorticoids, methotrexate and rituximab). The clinical course, laboratory work, imaging studies, histological analysis and response to treatment were thoroughly reviewed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Initial conjunctival culture revealed\n C<\/jats:italic>\n .\u2009\n kroppenstedtii<\/jats:italic>\n and clindamycin and vancomycin was initiated. Despite escalating antimicrobials, the patient developed progressive inflammation with sinus destruction, cutaneous fistula and cheek abscess, requiring orbital exenteration. The biopsies revealed chronic inflammation with multinucleated giant cells, focal necrosis and small\u2010vessel vasculitis. ANCA remained negative, and subsequent testing was negative. High\u2010dose prednisolone improved the patient, prompting the discontinuation of methotrexate because of pancytopenia. Rituximab\u2010induced remission allowed for steroid tapering and rituximab maintenance, which controlled the disease without complications.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n This case illustrates a rare, localised ANCA\u2010negative necrotizing small\u2010vessel vasculitis with destructive orbital involvement and initial detection of\n C.\u2009kroppenstedtii<\/jats:italic>\n . Although the pathogenic significance of this finding remains uncertain, the case highlights the importance of comprehensive microbiological and immunological evaluation in atypical destructive inflammatory disease. Sustained disease control was achieved with immunosuppressive therapy including rituximab after persistent infection had been excluded.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cti2.70119","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T08:41:38Z","timestamp":1786437698000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sustained response to rituximab in an ANCA\u2010negative necrotizing vasculitis with initial detection of\n Corynebacterium kroppenstedtii<\/i>"],"prefix":"10.1002","volume":"15","author":[{"given":"Nadine","family":"Al\u2010Azem","sequence":"first","affiliation":[{"name":"Section of Rheumatology and Clinical Immunology, Department of Medicine D University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Knothe","sequence":"additional","affiliation":[{"name":"Section of Rheumatology and Clinical Immunology, Department of Medicine D University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u2010Dirk","family":"Raguse","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Fachklinik Hornheide M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Nierkamp","sequence":"additional","affiliation":[{"name":"Clinic for Ear, Nose, and Throat Disorders University Hospital M\u00fcnster M\u00fcnster Germany"},{"name":"Center for Diseases of the Upper Airway University Clinic M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1622-6077","authenticated-orcid":false,"given":"Achim Georg","family":"Beule","sequence":"additional","affiliation":[{"name":"Clinic for Ear, Nose, and Throat Disorders University Hospital M\u00fcnster M\u00fcnster Germany"},{"name":"Center for Diseases of the Upper Airway University Clinic M\u00fcnster M\u00fcnster Germany"},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery University Medicine Greifswald Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Rudack","sequence":"additional","affiliation":[{"name":"Clinic for Ear, Nose, and Throat Disorders University Hospital M\u00fcnster M\u00fcnster Germany"},{"name":"Center for Diseases of the Upper Airway University Clinic M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedericke","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Gerhard\u2010Domagk\u2010Institute of Pathology University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Kerlikowki","sequence":"additional","affiliation":[{"name":"Gerhard\u2010Domagk\u2010Institute of Pathology University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Wardelmann","sequence":"additional","affiliation":[{"name":"Gerhard\u2010Domagk\u2010Institute of Pathology University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Pavenst\u00e4dt","sequence":"additional","affiliation":[{"name":"Section of Rheumatology and Clinical Immunology, Department of Medicine D University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin A","family":"Kriegel","sequence":"additional","affiliation":[{"name":"Section of Rheumatology and Clinical Immunology, Department of Medicine D University Hospital M\u00fcnster M\u00fcnster Germany"},{"name":"Department of Translational Rheumatology and Immunology, Institute for Musculoskelettal Medicine University of M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2982-8253","authenticated-orcid":false,"given":"Rebecca","family":"Hasseli","sequence":"additional","affiliation":[{"name":"Section of Rheumatology and Clinical Immunology, Department of Medicine D University Hospital M\u00fcnster M\u00fcnster Germany"},{"name":"Institute of Immunology University of M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2025.102605"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-42307-7"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2008.07.020"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2025.102056"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-022-01083-5"}],"container-title":["Clinical & Translational 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