Related Experiment Video
Updated: Jun 15, 2026
In Vivo Mouse Model of Spinal Implant Infection
Published on: June 23, 2020
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
Abstract:
Propionibacterium acnes was previously considered a contaminant and its role in spine infection has been understated. Although rare, such infections are present especially after instrumented spine surgery. They are usually delayed and hard to diagnose. Delayed infection should be suspected in patients with pain and a history of spine surgery. In this article, we review the diagnostic challenges associated with delayed P. acnes infection after spine surgery, guided by relevant studies in the literature. The medical databases of PubMed, Medline and Embase were searched for the literature on delayed spine infections and osteomyelitis following spinal procedures. The medical literature was reviewed for articles published between 1955 and 2008. Our review of the literature revealed 13 cases of P. acnes osteomyelitis following surgical procedures involving the spine. We also present a clinical case of delayed P. acnes osteomyelitis following discectomy and fusion with instrumentation.
Insights
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.
