Propionibacterium acnes and Staphylococcus epidermidis olecranon bursitis/osteomyelitis: a case involving surgical and antibiotic treatment.
John G SkedrosMicheal G AdondakisEric M BrownMarquam R OliverPublished in: BMJ case reports (2018)
This report describes a 63-year-old generally healthy male with septic olecranon bursitis caused by Propionibacterium acnes The patient sustained a small laceration after striking the posterior aspect of his left elbow on a metal railing when he was at a public swimming pool. We concluded that P. acnes was not initially detected because cultures were only kept for 5 days. Consequently, initial antibiotic treatment failed. P. acnes and Staphylococcus epidermidis grew in a subsequent tissue culture. The infection did not respond to intravenous vancomycin although soft-tissue debridements were done. This likely reflected the presence of olecranon osteomyelitis (seen on MRI scans) in addition to inadequate treatment with this antibiotic in the setting of a polymicrobial infection. Eventually, the infection was eradicated with multiple soft-tissue debridements in addition to the continuation of vancomycin with daily intravenous piperacillin/tazobactam that was added for the final 4 weeks of antibiotic treatment.
Keyphrases
- soft tissue
- staphylococcus aureus
- healthcare
- biofilm formation
- magnetic resonance imaging
- computed tomography
- emergency department
- physical activity
- cystic fibrosis
- acute kidney injury
- magnetic resonance
- low dose
- high dose
- methicillin resistant staphylococcus aureus
- case report
- smoking cessation
- drug induced
- adverse drug