Cerebral empyema and abscesses due to Cutibacterium acnes
| Autor: | Christian Chidiac, Anne Tristan, Zoé Cavalli, E. Jouanneau, C. Pietropaoli, Florence Ader, Tristan Ferry, Anne Conrad, J. Guyotat |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Bone flap Delayed Diagnosis Brain Abscess Neuroimaging Surgical Flaps 03 medical and health sciences Medicine Humans Surgical Wound Infection Abscess Empyema Brain abscess Gram-Positive Bacterial Infections Aged Retrospective Studies Skin 0303 health sciences Cutibacterium acnes Virulence 030306 microbiology business.industry Coinfection Osteomyelitis Skull Drug Resistance Microbial Middle Aged Propionibacteriaceae medicine.disease Combined Modality Therapy Surgery Anti-Bacterial Agents Infectious Diseases Drainage Female Neurosurgery Implant business Craniotomy Follow-Up Studies |
| Zdroj: | Medecine et maladies infectieuses. 50(3) |
| ISSN: | 1769-6690 |
| Popis: | Introduction Cutibacterium acnes is a commensal bacterium of the skin, frequently reported in prosthetic shoulder or spinal implant infections, but rarely in cranial and intracranial infections. Methods We retrospectively reviewed patients with intracranial samples positive to Cutibacterium acnes managed in the neurosurgical units of our hospital of Lyon, France, between 2008–2016. Results We included 29 patients, of whom 23 had empyema (with or without abscess), 17 had cranial osteomyelitis, and six only had abscess. Prior neurosurgery was reported in 28 patients, and the remaining patient had four spontaneous abscesses. Twelve patients had polymicrobial infections, including methicillin-susceptible Staphylococcus in 11 cases. The clinical diagnosis was difficult because of indolent and delayed symptoms: a CT scan or MRI was required. Thirteen patients (52%) had material at the infection site. All patients with bone flap implant or bones from biological banks had a bone flap-associated infection. Drainage was surgically performed in 25 cases or by CT scan-guided aspiration in four cases. All patients received an adapted antibiotic therapy (from three weeks to six months). The outcome was favorable in 28 patients. Three patients relapsed during the antibiotic therapy, requiring further surgery. Conclusion Cutibacterium acnes can be responsible for postoperative empyema and cerebral abscesses, with particular indolent forms, which make their diagnosis difficult. They are often polymicrobial and associated with bone flap osteomyelitis. Their outcome is favorable after drainage and adapted antibiotic therapy. |
| Databáze: | OpenAIRE |
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