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Successful management of central nervous system infection due to Propionibacterium acnes with vancomycin and

Michael E Fincher1, Mary Forsyth, Scott Y Rahimi

  • 1Section of Infectious Diseases, Department of Internal Medicine, Medical College of Georgia, Augusta, GA, USA. mfincher5@yahoo.com

Southern Medical Journal
|February 1, 2005
PubMed

Insights

Propionibacterium acnes can cause neurosurgical infections, often after shunt procedures. Prolonged vancomycin and doxycycline successfully treated a central nervous system infection in a patient after craniotomy, avoiding further surgery.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Microbiology

Background:

  • Propionibacterium acnes (P. acnes) is an emerging cause of neurosurgical infections.
  • P. acnes infections are most frequently associated with neurosurgical shunt procedures.
  • Optimal treatment for P. acnes central nervous system (CNS) infections remains undefined.

Observation:

  • A patient developed a P. acnes CNS infection following a craniotomy for subdural hematoma.
  • The patient presented with neurological symptoms and radiographic evidence of infection.

Findings:

  • Successful treatment of P. acnes CNS infection was achieved with prolonged vancomycin and doxycycline therapy.
  • The patient showed improvement in neurological symptoms and radiographic resolution of the infection.
  • Neurosurgical intervention was not required due to the effectiveness of the antibiotic regimen.

Implications:

  • This case highlights the potential for P. acnes to cause CNS infections post-neurosurgery.
  • Prolonged vancomycin and doxycycline therapy can be an effective treatment strategy for P. acnes CNS infections.
  • Conservative management with antibiotics may obviate the need for surgical intervention in select cases.

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