Friday, December 7, 2012

Delayed appearance of Propionibacterium in a revision reverse

Last month we posted the case of a revision for a failed reverse total shoulder. As per our protocol, we withheld antibiotics until cultures could be obtained and, after vigorous debridement and irrigation, placed him on antibiotics until the culture results were finalized.  Even though there was no clinical evidence of infection, the humeral tray cultured two species of staph in the first week. At 17 days, all specimens were positive for Propionibacterium.

Humeral tray 1+ Staph Aureus
Humeral tray 1+ Staph lugdunensis
Humeral tray 1+ Priopionibacterium
Tray stem 1+ Priopionibacterium
Humeral membrane 1 1+ Priopionibacterium
Humeral membrane 2 1+ Priopionibacterium

He is doing exceedingly well with respect to his shoulder comfort and function. We will continue his antibiotic management.

It's all pretty interesting.


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