Propionibacterium acnes Meningoencephalitis-Report of a Case Not Related to a Shunt

Propionibacterium acnes is a Gram-positive, pleomorphic, anaerobic bacilli widely distributed in nature and has traditionally been considered nonpathogenic in man. Several reports have recommended that ”Propionibacterium acnes” isolated from cerebrospinal fluid (CSF) should not be regarded as a ”contaminant”. Most reported infections were shunt related. We report a 31-year-old woman who developed headache and diplopia for two weeks without a prior history of CSF shunt surgery. CSF studies revealed pleocytosis with predominant lymphocytes and a normal sugar profile. Cultures yielded a single bacterial species, ”Propionibacterium acnes”. T2-FLAIR brain magnetic resonance imaging (MRI) showed a focal hyperintensity in the left occipital lobe. Follow-up CSF culture after intravenous penicillin G treatment demonstrated no growth, along with a subjectively good clinical outcome. We thus concluded that this rare anaerobic meningoencephalitis, although unassociated with shunts or foreign bodies, should be adequately treated instead of discounted as a common contaminant from lumbar puncture. As far as we know, this is the first case reported in Taiwan.

並列關鍵字

Propionibacterium acnes ； meningoencephalitis ； anaerobic

國際替代計量

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