Arthroplasty Infection by Priopionibacterium granulosum Treated With Reimplantation Despite Ongoing Purulent-Appearing Fluid Collection.
ABSTRACT We present the first case of infection in a native or prosthetic joint by Propionibacterium granulosum in which a patient developed symptoms of prosthetic hip infection 5 years after primary surgery. The patient required multiple operative debridements to eradicate the infection and was successfully reimplanted despite an ongoing purulent-appearing, although sterile, fluid collection at the time of reimplantation. There is no clinical or laboratory evidence of infection at 3 years post-reimplantation, and the patient has a well-functioning total hip arthroplasty. P granulosum is a low-virulence but highly-inflammatory organism. It seems to produce a large fluid collection that may require multiple debridements. To our knowledge, there are no reported cases of native or prosthetic joint infection from P granulosum. We present the first case here.
- SourceAvailable from: nih.gov[Show abstract] [Hide abstract]
ABSTRACT: Acne vulgaris is a self-limiting skin disorder seen primarily in adolescents, whose aetiology appears to be multifactorial. The four main aetiological factors are hypercornification of the pilosebaceous duct, increased sebum production, colonization with Propionibacterium acnes, and subsequently the production of inflammation. Considerable investigation has addressed the immunologic reaction to extracellular products produced by the acne-causing organism, P acnes. The immunologic response involves both humoral and cell-mediated pathways. Further research should clarify the role of complement, cytotoxins, and neutrophils in this acne-forming response.Postgraduate Medical Journal 07/1999; 75(884):328-31. · 1.55 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: We review recent advances in the prevention, diagnosis and treatment of infections associated with joint prostheses and internal fixation devices. The perioperative antimicrobial prophylaxis should be administered 60-30 min before incision or before inflation of the tourniquet. New diagnostic approaches include sonication of removed implants to dislodge adherent microorganisms growing in biofilms and the use of molecular techniques to improve diagnostic yield. Treatment of implant-associated infections without removal of the device is an established option for selected patients. Treatment with rifampin combinations in staphylococcal infections is crucial for success. As demonstrated in vitro, in animal studies and in clinical trials, quinolones are suitable combination agents with rifampin against susceptible staphylococci, but increasing antimicrobial resistance requires evaluation of alternative combination agents, such as quinpristin-dalfopristin, linezolid, and daptomycin, although clinical experience is limited. New antimicrobial agents, such as dalbavancin, tigecycline, iclaprim, and novel rifamycin derivatives are studied. Better understanding of the interaction between microorganisms, the implant and the host may improve our current approach to the diagnosis and treatment of implant-associated infections. The treatment modality depends on duration of infection, stability of the implant, antimicrobial susceptibility of the pathogen and condition of the surrounding soft tissue.Current Opinion in Infectious Diseases 09/2006; 19(4):349-56. · 5.03 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Laser in situ keratomileusis (LASIK) was performed in the left eye of a 57-year-old man for residual ametropia after phacoemulsification. The patient was given topical tobramycin and a corticosteroid for 1 week postoperatively. Fifteen days later, he developed 3 corneal infiltrates beneath the flap with a gas bubble, suggesting an anaerobic infection. Tobramycin and ofloxacin were administered every 2 hours, but the condition worsened. Corneal scrapings were taken from beneath the flap for microbiological cultures and a polymerase chain reaction (PCR) test. The PCR amplification was negative for fungi and mycobacteria and positive for bacterial DNA. Sequence analysis showed Propionibacterium granulosum as the causal agent, but cultures were negative. Treatment with vancomycin and cefazolin led to clinical improvement, with resolution of corneal infiltrates. Anaerobic microorganisms can cause keratitis after LASIK. Polymerase chain reaction amplification and DNA typing can help detect microorganisms involved in these ocular infections.Journal of Cataract and Refractive Surgery 09/2004; 30(8):1790-4. · 2.55 Impact Factor