Late infection of total hip arthroplasty with Propionibacterium acnes: a case and review of the literature.

A 24-year-old woman had a Propionibacterium acnes infection of a total hip arthroplasty. The clinical course of an infection with this organism has been previously described in detail. The radiologic appearance of a well-circumscribed lytic defect in the femoral shaft is also an unusual if not unique presentation of late infection after total hip arthroplasty. Moreover, simple excision of this infected nidus coupled with antibiotic therapy achieved a complete clinical recovery, in sharp contrast to the more radical procedures generally required for other infections. The predominance of this organism in skin flora, as well as its presence as a contaminant in the operating room environment, implicates Propionibacterium acnes as a potential intraoperative pathogen.