Successful management of central nervous system infection due to Propionibacterium acnes with vancomycin and doxycycline

Propionibacterium acnes is an infrequent but increasingly recognized cause of neurosurgical infections. In this setting, it has been most commonly reported as complicating neurosurgical shunt procedures. The optimum therapy for central nervous system infections caused by P. acnes has not been established. The authors report on a patient who had development of P. acnes central nervous system infection after craniotomy for subdural hematoma. This case was successfully treated with prolonged therapy with vancomycin and doxycycline. Neurologic symptom improvement and radiographic resolution were documented on this regimen, and neurosurgical intervention was not required.