Chronic Propionibacterium acnes prosthesis joint infection manifesting as a large abscess with gas, without prosthesis loosening.

A 78-year-old woman with diabetes, hypertension and severe omarthrosis, had a left total shoulder arthroplasty in May 2010. In September 2010, the patient developed axillar abscess, without fever or pain, which was incised. Propionibacterium acnes grew in cultures and the patient received amoxicillin-clavulanate for 10 days. In 2011, it reoccurred, with abscess formation that gradually increased in size during several weeks and reached 5×8 cm in diameter (figure 1A). C reactive protein was elevated (94 mg/L), but the patient did not have fever. X-ray examination did not show prosthesis loosening, but a distal cortical thickening of …