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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 4, issue 1
J. Bone Joint Infect., 4, 40–49, 2019
https://doi.org/10.7150/jbji.29153
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 4, 40–49, 2019
https://doi.org/10.7150/jbji.29153
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.

Case report 29 Jan 2019

Case report | 29 Jan 2019

Cutibacterium (formerly Propionibacterium) acnes clavicular infection

Musa Zaid, Madisyn R. Chavez, Adrianna E. Carrasco, Melissa N. Zimel, Alan L. Zhang, Andrew E. Horvai, Thomas M. Link, and Richard J. O'Donnell Musa Zaid et al.
  • University of California San Francisco, Department of Orthopaedic Surgery

Keywords: Cutibacterium acnes, Propionibacterium acnes, osteomyelitis, clavicle, debridement, infection, shoulder

Abstract. Cutibacterium (formerly Propionibacterium) acnes13, 16 is a slow growing, gram-positive bacteria that is naturally found in higher concentrations as skin flora on the chest and back, as well as in other areas with greater numbers of hair follicles.25, 37 Most of the reported cases of C. acnes shoulder girdle infection follow arthroplasty surgery,18, 20, 26, 27, 32, 35 which then often requires debridement, administration of intravenous antibiotics, and surgical revision of the implanted device.12, 15, 21, 28-30 In a recent study, 56% of 193 shoulder revisions had a positive culture, 70% of which grew C. acnes.30 Despite the relatively common presumed association of C. acnes humeral osteomyelitis with prosthetic infection, infection of the scapula or clavicle secondary to C. acnes is rare.4, 23, 36 Osteomyelitis of the clavicle involving any organism is also an uncommon event that can arise spontaneously via presumed hematogenous spread, or secondary to open fractures or internal fixation.6, 33 The most commonly found organism in clavicular osteomyelitis is Staphylococcus aureus.9 We here report two cases of clavicular infection secondary to C. acnes that were not associated with implants.

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