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Splenic abscess caused by Propionibacterium acnes
Abstract:
A 59-year-old male diabetic was admitted with an acute myocardial infarction and had recurrent. Propionibacterium acnes bacteremia. Fifteen months after the initial admission a splenectomy was required for removal of a large splenic abscess caused by P. acnes. Although this organism represents part of the normal skin flora, its presence of blood cultures requires serious evaluation since it may signify clinical disease, not merely contamination of blood cultures by skin flora.
Insights
Propionibacterium acnes bacteremia can indicate serious infection, not just skin contamination. This case highlights the need for careful evaluation of P. acnes in blood cultures, even in diabetic patients with myocardial infarction.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Diabetes mellitus and acute myocardial infarction are significant risk factors for various infections.
- Propionibacterium acnes (P. acnes) is a common skin commensal, often considered a contaminant in blood cultures.
Observation:
- A 59-year-old diabetic male with acute myocardial infarction presented with recurrent P. acnes bacteremia.
- A large splenic abscess caused by P. acnes necessitated a splenectomy 15 months after initial admission.
Findings:
- Recurrent P. acnes bacteremia in this patient led to a significant clinical sequela (splenic abscess).
- The case demonstrates that P. acnes can be a true pathogen, not solely a contaminant.
Implications:
- Bloodstream infections with P. acnes warrant thorough investigation to rule out underlying pathology.
- Clinicians should maintain a high index of suspicion for P. acnes as a causative agent of serious infections, particularly in immunocompromised or comorbid patients.