Journal Article

Propionibacterium avidum infection following breast reduction: high morbidity from a low-virulence pathogen

Pietro G. di Summa, Adrien Yvon, Lorenz Larcher, Wassim Raffoul and Nathalie Koch

in Journal of Surgical Case Reports

Published on behalf of JSCR Publishing Ltd

Volume 2015, issue 2
Published online February 2015 | e-ISSN: 2042-8812 | DOI: https://dx.doi.org/10.1093/jscr/rjv002

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Propionibacterium avidum is a common inhabitant of sebaceous glands, traditionally considered to be of low virulence and generally found on implanted foreign material. We report a rare case of P. avidum breast abscess, causing severe morbidity following breast reduction surgery. A 36-year-old woman presented with a non-painful wound discharge 3 weeks postoperatively, and was treated conservatively. She was readmitted 7 weeks postoperatively with a red and tender breast. A purulent discharging abscess was drained under ultrasound guidance. A 2-week intravenous course of amoxicillin–clavulanic acid, followed by oral replacement for a month resulted effective. Serial ultrasound imaging was useful in treatment decision-making. The infective potential of P. avidum may be underappreciated. Proximity of sutures to the axilla, tobacco smoking and the potential for resorbable sutures to host bacteria may predispose to infection, and should raise the clinician's awareness.

Journal Article.  1300 words.  Illustrated.

Subjects: Transplant Surgery

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