Propionibacterium acnes: pathogen in central nervous system shunt infection. Report of three cases including immune complex glomerulonephritis.
Propionibacterium acnes is a pleomorphic gram-positive anaerobic rod usually isolated as a contaminant from skin. We report three cases of P. acnes infection of central nervous system shunts for hydrocephalus. The organism was seen repeatedly on gram stain in a specimen of shunt fluid in all three cases; initially, it was regarded as a contaminant. In addition, two of the patients had precipitins to extracts of their organism. Serum from normal control subjects had no such precipitins. One of the patients had an immune-complex glomerulonephritis--an entity not previously associated with anaerobic organisms. All three patients recovered after removal of the shunt and treatment with antibiotics. P. acnes is a significant pathogen in patients with central nervous system shunts.
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000276:immunology / Q000382:microbiology*; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000209:etiology*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000601:surgery; D007105:Immune Complex Diseases / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011233:Precipitin Tests; D011424:Propionibacterium / Q000302:isolation & purification; D011425:Propionibacterium acnes / Q000276:immunology