title: Propionibacterium Acnes Infection of a Metacarpophalangeal Joint Arthroplasty.
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.
authors.affiliation: The Bernard O'Brien Institute of Microsurgery, Fitzroy, Victoria, Australia; Department of Orthopaedic Surgery, Hand Surgery Unit, Hôpital Trousseau, Tours, France; UMR Imagerie et Cerveau, Université François-Rabelais, Tours, France. Electronic address: bacle.guillaume@wanadoo.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bacle
authors.affiliation: Division of Hand Surgery, Department of Orthopaedics, Dandenong Hospital, Melbourne, Australia.
authors.forename: Sheena K
authors.initials: SK
authors.lastname: Sikora
authors.affiliation: Division of Hand Surgery, Department of Orthopaedics, Dandenong Hospital, Melbourne, Australia; Department of Surgery, Monash Medical Centre, Monash University, Melbourne, Australia; Melbourne Orthopaedic Group, Windsor, Victoria, Australia.
authors.forename: Eugene T H
authors.initials: ETH
authors.lastname: Ek
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000295:instrumentation*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008662:Metacarpophalangeal Joint; D011425:Propionibacterium acnes / Q000302:isolation & purification*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D012086:Reoperation
chemical_list: D000900:Anti-Bacterial Agents
keywords: Propionibacterium acnes; arthroplasty; infection; metacarpophalangeal joint; revision