Sarah M Kranick1, Christopher Vinnard, Dennis L Kolson. 1. Hospital of University of Pennsylvania, Department of Neurology, 3 W Gates, 3400 Spruce St, Philadelphia, PA 19104, USA. sarah.kranick@uphs.upenn.edu
Abstract
OBJECTIVE: To describe a case of Propionibacterium acnes infection arising 10 years after neurosurgery and to review the literature regarding similar cases and their treatment. DESIGN: Case report. SETTING: Hospital of the University of Pennsylvania. PATIENT: A 70-year-old man with an intracerebral abscess and 2 biopsies culture positive for P acnes 10 years after subdural hematoma evacuation. Intervention Surgical biopsy followed by 6 weeks of intravenous vancomycin. MAIN OUTCOME MEASURES: Magnetic resonance imaging, neurologic examination, and microbiology culture results. RESULTS: Biopsies obtained from abscesses grew only P acnes. Magnetic resonance imaging and serial neurological examinations showed marked improvement after 6 weeks of intravenous vancomycin. CONCLUSIONS: Infection by P acnes can complicate neurosurgical procedures as late as 10 years after surgery and therefore should be considered in the evaluation of patients presenting with neurologic signs and symptoms with a history of neurosurgery.
OBJECTIVE: To describe a case of Propionibacterium acnes infection arising 10 years after neurosurgery and to review the literature regarding similar cases and their treatment. DESIGN: Case report. SETTING: Hospital of the University of Pennsylvania. PATIENT: A 70-year-old man with an intracerebral abscess and 2 biopsies culture positive for P acnes 10 years after subdural hematoma evacuation. Intervention Surgical biopsy followed by 6 weeks of intravenous vancomycin. MAIN OUTCOME MEASURES: Magnetic resonance imaging, neurologic examination, and microbiology culture results. RESULTS: Biopsies obtained from abscesses grew only P acnes. Magnetic resonance imaging and serial neurological examinations showed marked improvement after 6 weeks of intravenous vancomycin. CONCLUSIONS: Infection by P acnes can complicate neurosurgical procedures as late as 10 years after surgery and therefore should be considered in the evaluation of patients presenting with neurologic signs and symptoms with a history of neurosurgery.
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