Propionibacterium acnes isolated from synovial tissue and fluid in a patient with oligoarthritis associated with acne and pustulosis

Abstract

This report describes the case of a patient with a 14-month course of severe oligoarthritis associated with acne. Pure cultures of Propionibacterium acnes were isolated from synovial tissue and synovial fluid specimens collected from the same joint after a 4-month interval. After 2 months of treatment with roxithromy-cin 300 mglday, rifampicin 1,200 mglday, and a nonste-roidal antiinflammatory drug (NSAID), followed by 4 months of treatment with azithromycin 1 gm/week and an NSAID, the synovitis persisted. Cultures of skin lesions and synovial fluid at this time were negative. Although P acnes has previously been isolated from bone specimens obtained from patients with osteitis associated with acne, this is the first report of the isolation of this microorganism from the synovial tissue of a patient with arthritis associated with acne. Our findings raise the question of the role of P acnes in the pathogenesis of arthritis associated with acne. Acne is a chronic inflammatory disease of the pilosebaceous follicles, characterized by the formation of comedones and erythematous papules and pustules, and less frequently, by nodules or cysts and ulcerative lesions that can lead to definitive scarring. Acne can be differentiated into acne vulgaris (thc common form that begins classically in thc prepubertal period and resolves by the mid-20s; significant lesions can still bc sccn in 3%

Propionibacterium acnes and Staphylococcus epidermidis Isolated from Refractory Endodontic Lesions Are Opportunistic Pathogens

“…Although traditionally considered to be relatively nonpathogenic, an increasing number of studies have implicated P. acnes as an opportunistic pathogen responsible for a wide range of infections and inflammatory conditions. In addition to its well-established role in the pathogenesis of acnes vulgaris (16,34), it has also been linked to synovitis-acnes-pustulosis-hyperostosis-osteitis syndrome (44,54), sarcoidosis (17), and prostate cancer (14). Recent studies have revealed trauma and surgery as the predisposing factors associated with numerous P. acnes infections, which include brain abscesses (36), osteomyelitis after lumbar puncture (1), discitis after surgery (23), spodylodiscitis following epidural catheterization (22,25), postoperative mediastinitis (19,58), endophthalmitis (7), and endocarditis (21).…”

Propionibacterium acnes and Staphylococcus lugdunensis Cause Pyogenic Osteomyelitis in an Intramedullary Nail Model in Rabbits

“…These findings may also have wider implications in relation to the involvement of such bacteria in other conditions, such as dental infection (57) and synovitis-acnes-pustulosis-hyperostosis-osteitis (SAPHO) syndrome (58,59). It would be interesting to follow the progression of both infections histologically over a longer time period and as it becomes more chronic in nature.…”

Multilocus Sequence Typing and Phylogenetic Analysis of Propionibacterium acnes

“…Opportunistic infections from which P. acnes strains are frequently isolated include biofilm-associated infections of prosthetic shoulders, hips, heart valves, and other medical devices that may become contaminated with skin microorganisms, endophthalmitis following ocular surgery, bone infections, including orthopedic implants, and dental root canal infections (16,27,28,29,32,34). Recently, P. acnes has been associated with prostate cancer due to its prevalence in affected prostate tissue, but its possible etiologic role has yet to be defined (1,7,9).…”