Post-operative spondylodiscitis due to Propionibacterium acnes : A case report

Propionibacterium acnes causing non-contiguous, multifocal spondylodiscitis in an immunosuppressed patient

This report describes a case of a spondylodiscitis in an immunocompromised patient with an HIV infection caused by Propionibacterium acnes The patient was admitted to hospital with a sudden loss of motor function and sensation in both of the patient's legs. A biopsy taken during the first debridement operation proved to be negative for Mycobacterium tuberculosis DNA and growth, but was positive for the growth of P. acnes Following a course of antibiotic therapy and the aforementioned debridement, the patient was moved to a specialised clinic for physical therapy. The patient's condition quickly deteriorated, and the patient once again required extensive debridement. Repeated spinal surgery, antibiotics for 12 weeks and subsequent rehabilitation resulted in almost complete recovery of sensorimotor limb function.

Lumbar Discitis and Osteomyelitis After a Spinal Stem Cell Injection?: A Case Report and Literature Review

CASE

A 32-year-old man developed lumbar discitis and osteomyelitis after receiving a cell-based injection for the treatment of degenerative disc disease. Initial cultures were negative, but he continued to worsen, and a repeat set of cultures was taken. On day 10, Cutibacterium acnes was isolated. He was then successfully treated with 12 weeks of intravenous antibiotics.

CONCLUSIONS

There is minimal regulation on the preparation or administration of cell-based interventions. It is important to consider slow growing organisms such as C. acnes in patients presenting with spinal infection with insidious onset after these treatments.