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06:02
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
[Post-surgery cerebral abscess due to Propionibacterium acnes]
Mariela S Zárate1, Diego Yahni, Martín Guevara
1Laboratorio de Bacteriología, Micología y Parasitología, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), 1425 Buenos Aires, Argentina. szarate@cemic.edu.ar
Medicina
|May 6, 2009
Summary
Propionibacterium acnes brain abscesses are rare post-neurosurgery complications. Prompt identification and targeted antibiotic therapy, including clindamycin, are crucial for successful patient outcomes.
Area of Science:
- Neuroscience
- Infectious Diseases
- Microbiology
Background:
- Propionibacterium acnes (P. acnes) is an uncommon cause of brain abscesses, particularly in the post-neurosurgical context.
- Rapid identification of P. acnes is essential for effective antibiotic selection and management of brain abscesses.
Observation:
- A patient with a history of glioblastoma developed a brain abscess caused by P. acnes nine months after tumor recurrence surgery.
- P. acnes was successfully isolated from both biopsy and purulent material, confirming the causative agent.
Findings:
- Minimum Inhibitory Concentration (MIC) values indicated susceptibility to clindamycin (0.250 µg/ml), penicillin (0.040 µg/ml), and amoxicillin (0.023 µg/ml), but resistance to metronidazole (256 µg/ml).
- The patient was treated with cefepime and metronidazole, followed by oral clindamycin, leading to resolution of the infection and no tumor recurrence at eight months.
Implications:
- This case highlights the importance of considering P. acnes in postoperative brain abscesses, even when rare.
- Effective management involves accurate pathogen identification, susceptibility testing, and a tailored antibiotic regimen, potentially including clindamycin for extended periods.
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