Acute Propionibacterium acnes Infection After Carpal Tunnel Release

Propionibacterium acnes (P. acnes) is a gram-positive, anaerobic, commensal organism found on nonglabrous skin, including the face, scalp, chest, and axilla. Recently, P. acnes is one of the more frequently recognized organisms causing postoperative infections in implant surgery of the shoulder, second to only Staphylococcus aureus (S. aureus), yet it is a rare postoperative complication of the wrist and hand. Multiple factors, including slow growth, multiorganism involvement, and selective growth media, complicate attributing a primary infection to P. acnes. We present a case of primary, acute P. acnes infection after carpal tunnel decompression, demonstrating the need for considering P. acnes for persistent postoperative hand and wrist infections.