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Infectious arthritis caused by Propionibacterium acnes: a report of two cases
M F Kooijmans-Coutinho1, H M Markusse, B A Dijkmans
1Department of Rheumatology, University Hospital, Leiden, The Netherlands.
Abstract:
Propionibacterium acnes, a micro-organism with low pathogenicity, rarely causes arthritis in a joint without a prosthesis. This report deals with two cases of P acnes infectious arthritis probably caused by direct penetration of the micro-organism into the joint space during arthrocentesis, despite the use of strict disinfection procedures. P acnes isolated from synovial fluid cannot be dismissed as a bothersome contaminant without due consideration of the clinical status of the individual patient.
Insights
Propionibacterium acnes (P acnes) can cause infectious arthritis in native joints, even with sterile procedures. Clinicians should consider P acnes in synovial fluid as a potential pathogen, not just a contaminant.
Area of Science:
- Microbiology
- Infectious Diseases
- Rheumatology
Background:
- Propionibacterium acnes (P acnes) is a bacterium with low pathogenicity.
- P acnes rarely causes arthritis in native joints, typically occurring in prosthetic joints.
Observation:
- Two cases of infectious arthritis caused by P acnes in native joints are presented.
- Infection likely resulted from direct microbial inoculation during arthrocentesis, despite aseptic techniques.
Findings:
- P acnes was isolated from synovial fluid in both patients.
- The clinical presentation and diagnostic challenges of P acnes infectious arthritis are highlighted.
Implications:
- P acnes in synovial fluid should not be dismissed as a contaminant without careful clinical evaluation.
- This underscores the importance of considering less common pathogens in joint infections.