[Post-surgery cerebral abscess due to Propionibacterium acnes].
Brain abscesses by Propioni-bacterium acnes are rare. The rapid identification of this pathogen is important in order to choice the appropriate antibiotic therapy. We describe the case of a patient with excision of a multiform glioblastoma who 9 months later presented a tumor recurrence. A subtotal tumor excision was made and implants chemotherapy were placed in the residual tumor. After one month of surgery the patient presented a brain abscess. A craniotomy for drainage was performed. P. acnes was isolated from the biopsy and from purulent material. Identification was made by conventional biochemical tests and by the API system 20 A. The Minimum Inhibitory Concentration (MIC) to clindamycin, penicillin, amoxicillin and metronidazole was determined. The values of MIC (microg/ml) obtained were: 0.250, 0.040, 0.023 and 256, respectively. The patient received cefepime and metronidazole intravenously during 30 days and completed treatment with oral clindamycin for 60 days, considering the possibility of adjacent bone involvement. Eight months after the drainage the patient had no evidence of infection or tumor recurrence. Although P. acnes is a rare cause of post-neurosurgical infection, it should be considered as a possible pathogen in postoperative brain abscesses.
Zárate
Mariela S
MS
Laboratorio de Bacteriología, Micología y Parasitología, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), 1425 Buenos Aires, Argentina. szarate@cemic.edu.ar
Yahni
Diego
D
Guevara
Martín
M
Smayevsky
Jorgelina
J
D001706:Biopsy; D001922:Brain Abscess / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D004322:Drainage; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D011425:Propionibacterium acnes / Q000302:isolation & purification*