Propionibacterium Acnes Infection of a Metacarpophalangeal Joint Arthroplasty

J Hand Surg Am. 2017 May;42(5):394.e1-394.e6. doi: 10.1016/j.jhsa.2017.01.023. Epub 2017 Mar 1.

Abstract

Neglected and underestimated in the past, Propionibacterium acnes is currently the most prevalent organism associated with deep prosthetic infections around the shoulder. Surprisingly, it has never been reported as a cause of infection in the hand. Here we report a case of a late presentation of a P. acnes infection in a metacarpophalangeal joint replacement, resulting in chronic low-grade pain with movement. The patient underwent a 2-stage revision, with initial removal of the prosthesis. Positive cultures for P. acnes required 15 days of extended incubation. The patient subsequently had 6 weeks of oral antibiotics followed by a second-stage revision with a Silastic implant.

Keywords: Propionibacterium acnes; arthroplasty; infection; metacarpophalangeal joint; revision.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement / adverse effects
  • Arthroplasty, Replacement / instrumentation*
  • Gram-Positive Bacterial Infections / diagnosis*
  • Gram-Positive Bacterial Infections / etiology
  • Gram-Positive Bacterial Infections / therapy
  • Humans
  • Joint Prosthesis / adverse effects*
  • Male
  • Metacarpophalangeal Joint*
  • Propionibacterium acnes / isolation & purification*
  • Prosthesis-Related Infections / diagnosis
  • Prosthesis-Related Infections / microbiology*
  • Prosthesis-Related Infections / therapy
  • Reoperation

Substances

  • Anti-Bacterial Agents