Propionibacterium acnes CNS shunt infections in adults: A 6-year retrospective review

M. R. Santiago, D. Amuh, K. Adal, M. Luciano, G. Hall, J. Goldfarb, C. Sabella

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Abstract

P.acnes CNS shunt infections are not well characterized. We retrospectively analyzed the clinical features and microbiological data on all adult patients who had a positive CSF culture for P. acnes since 1990. Patients who did not have CNS shunts were excluded. Patients were divided into 3 groups: 1)Infected patients had signs and symptoms of CNS infection and either: (A) 2 positive CSF and/or shunt component cultures OR (B) 1 positive CSF gram stain and 1 positive CSF and/or shunt component culture. 2)Non-infected patients were with or without signs and symptoms of CNS infection but lacked supportive microbiological data as described above. 3)Co-infected patients met the infected group criteria but had other organisms isolated from the CSF in addition to P.acnes. 30 patients(aged 21-77 yrs) with CNS shunts had P. acnes isolated from their CSF. Of these, 11 were deemed infected, 13 were non-infected, and 6 were co-infected. Chronic headache was the most frequent symptom in all three groups. Abdominal complaints were more common in the infected group. There were no risk factors that differentiated the 3 groups. 2 patients in the infected group had > 500/mm3 in the CSF with PMN predominance and one had hypoglycorrhachia. All patients in the non-infected and co-infected groups had CSF WBC <100/mm3. 5 patients in the infected group did not have pleocytosis. Other organisms isolated from the co-infected group were coagulase-negative staphylococci and Candida parapsilosis. In conclusion, P. acnes may be a more common cause of CNS shunt infection than previously recognized. The signs and symptoms of P.acnes CNS shunt infections are nonspecific. These infections may be associated with a marked pleocytosis and hypoglycorrhachia, although normal CSF parameters are common.

Original languageEnglish (US)
Number of pages1
JournalClinical Infectious Diseases
Volume25
Issue number2
StatePublished - Dec 1 1997

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ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Santiago, M. R., Amuh, D., Adal, K., Luciano, M., Hall, G., Goldfarb, J., & Sabella, C. (1997). Propionibacterium acnes CNS shunt infections in adults: A 6-year retrospective review. Clinical Infectious Diseases, 25(2).