Propionibacterium acnes Infection with Intracerebral Abscess in Deep Brain Stimulation

Frid, Ilya; Lewis, Rebecca P; Marsans, Maria; Farrokhi, Farrokh

doi:10.4172/2325-9701.1000285

Cited by 2 publications

(3 citation statements)

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“…Typically, these infections have a wide degree of variance in presentation (i.e., extradural, subdural infections, brain abscesses, and meningitis) and in temporality (i.e., weeks to years after neurosurgical procedures). [13][14][15][16][17] There are only three reports of P. Acnes causing a brain abscess in a patient without known risk factors (i.e., immunosuppression), and without prior instrumentation or neurosurgical intervention (Table 1). 18,1918,19,24 Herein, we describe a case of an immunocompetent man without prior neurosurgery, and predisposing factors who presented with a P. Acnes brain abscess with intraventricular rupture.…”

Section: Brain Abscessesmentioning

confidence: 99%

“…Typically, these infections have a wide degree of variance in presentation (i.e., extradural, subdural infections, brain abscesses, and meningitis) and in temporality (i.e., weeks to years after neurosurgical procedures). 13 , 14 , 15 , 16 , 17 There are only three reports of P . Acnes causing a brain abscess in a patient without known risk factors (i.e., immunosuppression), and without prior instrumentation or neurosurgical intervention (Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Propionibacterium Acnes abscess with intraventricular rupture in an immunocompetent adult without prior neurosurgical intervention

Smith

Cruz‐Gordillo

Luiselli

et al. 2022

Clinical Case Reports

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Section: Brain Abscessesmentioning

confidence: 99%

“…Typically, these infections have a wide degree of variance in presentation (i.e., extradural, subdural infections, brain abscesses, and meningitis) and in temporality (i.e., weeks to years after neurosurgical procedures). 13 , 14 , 15 , 16 , 17 There are only three reports of P . Acnes causing a brain abscess in a patient without known risk factors (i.e., immunosuppression), and without prior instrumentation or neurosurgical intervention (Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Propionibacterium Acnes abscess with intraventricular rupture in an immunocompetent adult without prior neurosurgical intervention

Smith

Cruz‐Gordillo

Luiselli

et al. 2022

Clinical Case Reports

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show abstract

“…[11][12][13][14][15] However, there are multiple case reports [15][16][17][18] and a few studies reporting an incidence ranging from 0.2% to 3% in sizable study populations. [19][20][21][22][23] Thus, although soft tissue infections predominate, intracranial infections do occur.…”

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confidence: 99%

Recrudescent infection after deep brain stimulator reimplantation

Moser

Chitta

O'Brien

et al. 2022

Journal of Neurosurgery

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OBJECTIVE The efficacy of deep brain stimulation (DBS) in treating the symptoms of movement disorders can be life changing for patients. Thus, the 5%–15% incidence of stimulator-related infection requiring removal of the device can be particularly disheartening. Although DBS system reimplantation is generally successful, this is not always the case. The literature is replete with publications describing the incidence of infection and the associated features. However, the literature is sparse in terms of information on the incidence of recurrent or recrudescent infection after system reimplantation. The goal of this paper was to evaluate factors leading to unsuccessful reimplantation of a DBS system following initial infection. METHODS Data were reviewed for all DBS procedures performed by one surgeon (K.L.H.) over 19 years including the infectious agent, location of infection, treatment regimen, and subsequent reimplantation of a DBS system and long-term outcome. RESULTS In this series of 558 patients who had undergone DBS surgery, 37 (6.6%) subsequently developed an infection. Infections with methicillin-sensitive Staphylococcus aureus, Enterobacter species, or coagulase-negative staphylococci were predominant. Four patients had cerebritis, one had meningitis, and the rest had soft tissue infections of the pocket or scalp. All had their entire DBS system explanted, followed by 4–6 weeks of intravenous antibiotics and surveillance for recrudescence for an additional period of at least 30 days. Twenty-five patients subsequently underwent DBS system reimplantation, and the procedure was successful in 22. Three of the 4 patients with cerebritis developed a subsequent wound infection after system reimplantation. None of the other 22 patients developed a recurrence. The odds ratio for developing a recurrent infection after cerebritis was 28.5 (95% CI 1.931–420.5, p = 0.007). CONCLUSIONS This study, the largest series of DBS system reimplantations following infection, demonstrated that most patients can have successful reimplantations without recurrent infection. However, patients who have had DBS-related cerebritis have a nearly 30-fold increased risk of developing reinfection after reimplantation. Alternative strategies for these patients are discussed.

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Propionibacterium acnes Infection with Intracerebral Abscess in Deep Brain Stimulation

Cited by 2 publications

References 0 publications

Spontaneous Propionibacterium Acnes abscess with intraventricular rupture in an immunocompetent adult without prior neurosurgical intervention

Spontaneous Propionibacterium Acnes abscess with intraventricular rupture in an immunocompetent adult without prior neurosurgical intervention

Recrudescent infection after deep brain stimulator reimplantation

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