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Focal infections of the central nervous system due to Propionibacterium acnes

J Richards1, H R Ingham, J Hickman

  • 1Department of Microbiology, Newcastle General Hospital, Newcastle upon Tyne, U.K.

Insights

Propionibacterium acnes rarely causes intracranial infections. This study highlights four cases where skin breaches led to P. acnes infections, suggesting it is an under-recognized pathogen in neurosurgery.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Microbiology

Background:

  • Intracranial infections are serious complications.
  • Propionibacterium acnes is a common skin commensal.
  • P. acnes is typically associated with superficial infections.

Observation:

  • Four patients presented with intracranial infections.
  • Infection etiology was linked to a breach in the skin barrier.
  • Propionibacterium acnes was identified as the causative agent in all cases.

Findings:

  • Propionibacterium acnes can be the sole causative agent of intracranial infections.
  • Skin tegument integrity breach is a potential route for P. acnes CNS invasion.
  • This challenges the perception of P. acnes as a non-pathogenic commensal in neurosurgical contexts.

Implications:

  • P. acnes should be considered in the differential diagnosis of post-operative intracranial infections.
  • Enhanced vigilance for P. acnes is warranted in neurosurgical patients with skin breaches.
  • Further research is needed to understand P. acnes pathogenesis in CNS infections.

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