title: Propionibacterium avidum infection following breast reduction: high morbidity from a low-virulence pathogen.
abstract: Propionibacterium avidum is a common inhabitant of sebaceous glands, traditionally considered to be of low virulence and generally found on implanted foreign material. We report a rare case of P. avidum breast abscess, causing severe morbidity following breast reduction surgery. A 36-year-old woman presented with a non-painful wound discharge 3 weeks postoperatively, and was treated conservatively. She was readmitted 7 weeks postoperatively with a red and tender breast. A purulent discharging abscess was drained under ultrasound guidance. A 2-week intravenous course of amoxicillin-clavulanic acid, followed by oral replacement for a month resulted effective. Serial ultrasound imaging was useful in treatment decision-making. The infective potential of P. avidum may be underappreciated. Proximity of sutures to the axilla, tobacco smoking and the potential for resorbable sutures to host bacteria may predispose to infection, and should raise the clinician's awareness.
authors: Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland pietro.di-summa@chuv.ch.
authors: Pietro G
authors: PG
authors: di Summa
authors: University Hospital of South Manchester, Manchester, UK.
authors: Adrien
authors: A
authors: Yvon
authors: Department of Plastic, Reconstructive and Aesthetic Surgery, BHB - PMU, Salzburg, Austria.
authors: Lorenz
authors: L
authors: Larcher
authors: Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
authors: Wassim
authors: W
authors: Raffoul
authors: Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
authors: Nathalie
authors: N
authors: Koch