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[Postoperative subdural empyema due to Propionibacterium acnes]
Youichi Uozumi1, Hiroshi Nawashiro, Reiko Higo
1Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa-city, Saitama 359-8513, Japan.
No Shinkei Geka. Neurological Surgery
|July 24, 2002
Summary
Propionibacterium acnes, a common skin bacterium, can cause serious post-neurosurgical infections, particularly with implants. This case highlights its rapid progression and suggests penicillin plus surgery as a treatment approach.
Area of Science:
- Microbiology
- Infectious Diseases
- Neurosurgery
Background:
- Propionibacterium acnes (P. acnes) are anaerobic, gram-positive bacteria commonly found on skin and mucous membranes.
- P. acnes is an underappreciated cause of infections, especially in neurosurgical patients with foreign bodies like shunts.
- Subdural empyema is a serious complication following neurosurgical procedures.
Observation:
- A rare case of postoperative subdural empyema is presented.
- The only pathogen isolated from the empyema was Propionibacterium acnes.
- The patient experienced an unusually rapid clinical deterioration.
Findings:
- Propionibacterium acnes can cause aggressive subdural empyema.
- The rapid clinical course observed in this case underscores the potential severity of P. acnes infections.
- Optimal antibiotic therapy for P. acnes infections remains to be definitively established.
Implications:
- This case emphasizes the importance of considering P. acnes in the differential diagnosis of post-neurosurgical infections.
- Prompt surgical intervention, including foreign body removal, is crucial.
- High-dose penicillin, in conjunction with surgical management, is recommended as the primary treatment strategy for P. acnes-related subdural empyema.