Case repository| Volume 42, ISSUE 5, P394.e1-394.e6, May 2017

Propionibacterium Acnes Infection of a Metacarpophalangeal Joint Arthroplasty

  • Guillaume Bacle
    Corresponding author: Guillaume Bacle, MD, PhD, The Bernard O’Brien Institute of Microsurgery, 42 Fitzroy St., Fitzroy, Victoria 3065, Australia.
    The Bernard O’Brien Institute of Microsurgery, Fitzroy, Victoria, Australia

    Department of Orthopaedic Surgery, Hand Surgery Unit, Hôpital Trousseau, Tours, France

    UMR Imagerie et Cerveau, Université François-Rabelais, Tours, France
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  • Sheena K. Sikora
    Division of Hand Surgery, Department of Orthopaedics, Dandenong Hospital, Melbourne, Australia
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  • Eugene T.H. Ek
    Division of Hand Surgery, Department of Orthopaedics, Dandenong Hospital, Melbourne, Australia

    Department of Surgery, Monash Medical Centre, Monash University, Melbourne, Australia

    Melbourne Orthopaedic Group, Windsor, Victoria, Australia
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Published:March 01, 2017DOI:
      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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