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Propionibacterium acnes causing delayed postoperative spine infection: review.
Rachid Haidar1, Marc Najjar, Asdghig Der Boghossian
1Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon. rh00@aub.edu.lb
Scandinavian Journal of Infectious Diseases
|March 5, 2010
Summary
Delayed Propionibacterium acnes spine infections are rare but serious, often occurring after surgery. Early suspicion in patients with pain and surgical history is crucial for diagnosis.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Propionibacterium acnes (P. acnes) was historically overlooked as a cause of spine infections.
- Delayed P. acnes infections are uncommon but pose diagnostic challenges, particularly post-instrumented spine surgery.
Purpose of the Study:
- To review the diagnostic difficulties of delayed P. acnes infections following spine surgery.
- To highlight the importance of considering P. acnes in post-operative spinal pain.
Main Methods:
- Literature search of PubMed, Medline, and Embase databases for P. acnes spine infections and osteomyelitis.
- Review of articles published between 1955 and 2008.
- Inclusion of a clinical case of delayed P. acnes osteomyelitis.
Main Results:
- The literature review identified 13 cases of P. acnes osteomyelitis after spinal procedures.
- A clinical case of delayed P. acnes osteomyelitis post-discectomy and fusion with instrumentation is presented.
Conclusions:
- Delayed P. acnes spine infections require high clinical suspicion in patients with post-operative pain.
- Improved diagnostic strategies are needed for these challenging infections.
