Neglected and underestimated in the past, Propionibacterium acnes is currently the most prevalent organism associated with deep prosthetic infections around the shoulder. Surprisingly, it has never been reported as a cause of infection in the hand. Here we report a case of a late presentation of a P. acnes infection in a metacarpophalangeal joint replacement, resulting in chronic low-grade pain with movement. The patient underwent a 2-stage revision, with initial removal of the prosthesis. Positive cultures for P. acnes required 15 days of extended incubation. The patient subsequently had 6 weeks of oral antibiotics followed by a second-stage revision with a Silastic implant.
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- Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen.Clin Microbiol Rev. 2014; 27: 419-440
- Propionibacterium acnes infections in shoulder surgery.Orthop Clin North Am. 2014; 45: 515-521
- Positive culture rate in revision shoulder arthroplasty.Clin Orthop Relat Res. 2009; 467: 2343-2348
- Propionibacterium acnes postoperative shoulder arthritis: an emerging clinical entity.Clin Infect Dis. 2008; 46: 1884-1886
- Propionibacterium acnes infection as an occult case of postoperative shoulder pain: a case series.Clin Orthop Relat Res. 2011; 469: 2824-2830
- Optimization of periprosthetic culture for diagnosis of Propionibacterium acnes prosthetic joint infection.J Clin Microbiol. 2011; 49: 2490-2495
- Epidemiology of bacterial hand infections.Int J Infect Dis. 2006; 10: 315-319
- Arthroplastic and osteosynthetic infections due to Propionibacterium acnes: a retrospective study of 52 cases, 1995–2002.Eur J Clin Microbiol Infect Dis. 2005; 24: 739-744
- Biofilm formation by Propionibacterium acnes is a characteristic of invasive isolates.Clin Microbiol Infect. 2009; 15: 787-795
- Biofilm formation by Propionibacterium acnes on biomaterials in vitro and in vivo: impact on diagnosis and treatment.J Biomed Mater Res A. 2007; 81: 705-709
Published online: March 01, 2017
Accepted: January 27, 2017
Received: November 10, 2016
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
The investigation was performed at the Melbourne Orthopaedic Group and Department of Orthopaedics, Dandenong Hospital, Monash University, Australia.
© 2017 by the American Society for Surgery of the Hand. All rights reserved.