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Cutibacterium (Propionibacterium) acnes Infection of the Native Wrist Joint
Cutibacterium (Propionibacterium) acnes (C. acnes, previously known as P. acnes) is an anaerobic organism that commonly colonizes the human skin. After Staphylococcus spp. and Streptococcus spp., it is a common organism associated with deep prosthetic shoulder joint infections. We describe the case of rapidly progressive arthropathy of the native wrist secondary to infection with C. acnes. Diagnosis was made on prolonged enrichment cultures. The patient went on to complete a long-term course of oral sulfamethoxazole-trimethoprim with clinical improvement.Mycobacterium longobardum Infection in the Hand
Mycobacterium longobardum is a slow-growing, nontuberculous mycobacterium that was first characterized in 2012. We report a case of M. longobardum infection in the right middle finger of a diabetic man. He underwent surgery for a presumed diagnosis of an epidermal inclusion cyst. Molecular diagnosis of the surgical specimens demonstrated M. longobardum through RNA polymerase β-subunit encoding gene sequencing. After surgery, the patient was treated with antibiotics and eventually cured of the infection.Propionibacterium Acnes Infection of a Metacarpophalangeal Joint Arthroplasty
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.
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