Propionibacterium acnes brain abscess appearing 10 years after neurosurgery.

OBJECTIVE

To describe a case of Propionibacterium acnes infection arising 10 years after neurosurgery and to review the literature regarding similar cases and their treatment.

DESIGN

Case report.

SETTING

Hospital of the University of Pennsylvania.

PATIENT

A 70-year-old man with an intracerebral abscess and 2 biopsies culture positive for P acnes 10 years after subdural hematoma evacuation. Intervention Surgical biopsy followed by 6 weeks of intravenous vancomycin.

MAIN OUTCOME MEASURES

Magnetic resonance imaging, neurologic examination, and microbiology culture results.

RESULTS

Biopsies obtained from abscesses grew only P acnes. Magnetic resonance imaging and serial neurological examinations showed marked improvement after 6 weeks of intravenous vancomycin.

CONCLUSIONS

Infection by P acnes can complicate neurosurgical procedures as late as 10 years after surgery and therefore should be considered in the evaluation of patients presenting with neurologic signs and symptoms with a history of neurosurgery.