痤疮丙酸杆菌性骨髓炎在开颅术后 23 年后发生：病例报告及文献复习。
Propionibacterium acnes osteomyelitis occurring 23 years after craniotomy: case report and review of literature.
机构信息
Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Washington 98195, USA.
出版信息
Neurosurgery. 2011 Sep;69(3):E773-9; discussion E779. doi: 10.1227/NEU.0b013e31821964ba.
BACKGROUND AND IMPORTANCE
Propionibacterium acnes is an uncommon pathogen in delayed surgical site infection, and its indolent course can complicate diagnosis and treatment. We report the longest delay between neurosurgery and P acnes infection reported.
CLINICAL PRESENTATION
Asymptomatic postoperative P acnes osteomyelitis and tumor recurrence occurring 23 years after initial craniotomy. Initial presentation was of tumor recurrence only, without signs or symptoms of infection. Calvarial osteomyelitis was unexpectedly discovered intraoperatively. Craniectomy and débridement were performed, and there was prolonged antibiotic therapy.
CONCLUSION
The longest delay between neurosurgery and asymptomatic P acnes infection is reported. We review the literature for P acnes infection and discuss biofilm formation and its role in delayed surgical infection.
背景与重要性
痤疮丙酸杆菌是延迟性手术部位感染的罕见病原体，其缓慢的病程可能会使诊断和治疗复杂化。我们报告了神经外科手术后感染痤疮丙酸杆菌的最长延迟时间。
临床表现
初次开颅术后 23 年无症状的痤疮丙酸杆菌骨髓炎和肿瘤复发。最初表现仅为肿瘤复发，没有感染的迹象或症状。术中意外发现颅骨骨髓炎。行颅骨切除术和清创术，并进行了长时间的抗生素治疗。
结论
报告了神经外科手术后和无症状的痤疮丙酸杆菌感染之间的最长延迟时间。我们查阅了文献中关于痤疮丙酸杆菌感染的资料，并讨论了生物膜的形成及其在延迟性手术感染中的作用。
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