Propionibacterium Acnes in Brain Biopsy Specimens in Suspected Neurosarcoidosis: A Case Presentation and Review of the Literature

Authors

Himat Gill, HCA HealthcareFollow
Steven Tran, HCA HealthcareFollow
Parker Kotlarz
Zeeshan Haque, HCA HealthcareFollow
Sean O'Leary, HCA HealthcareFollow
Joseph Cahill, HCA HealhcareFollow

Division

North Florida

Hospital

West Florida Hospital

Document Type

Case Report

Publication Date

9-20-2022

Keywords

Propionibacterium acnes, Brain biopsy, Neurosarcoidosis, Sarcoidosis, Granulomas

Disciplines

Bacterial Infections and Mycoses | Hemic and Lymphatic Diseases | Nervous System Diseases | Rehabilitation and Therapy

Abstract

Summary

Sarcoidosis is a rare diagnostic entity characterized by non-caseating granulomatous formation with the exact antigenic etiology being unknown at this time. This case report is novel because, to our knowledge, this is only the second reported case of propionibacterium acnes (P. acnes) isolated from a brain biopsy in a patient with suspected central nervous system granulomatous disease. This case report provides further evidence of P. acnes as a potential cause for sarcoidosis and neurosarcoidosis.

Objective

This report aims to present a rare case of neurosarcoidosis in a patient with Propionibacterium acnes (P. acnes) isolated from a brain biopsy.

Background

Sarcoidosis is a rare diagnostic entity characterized by non-caseating granulomatous formation with the exact antigenic etiology being unknown at this time.

Case presentation

An elderly male presented to the hospital with a variety of neurological complaints including worsening memory, weakness, and word finding difficulty. An MRI scan revealed a neuroinflammatory process of unknown etiology. Biopsy demonstrated granulomatous disease with micro abscesses. Anaerobic biopsy cultures eventually grew P. acnes in one of the pathology specimens.

Conclusions

This case report provides further evidence of P. acnes as a potential cause for sarcoidosis and neurosarcoidosis because, to our knowledge, this is only the second reported case of P. acnes isolated from a brain biopsy in a patient with suspected central nervous system granulomatous disease.

Publisher or Conference

Neuroimmunology Reports

Recommended Citation

Gill H, Tran S, Kotlarz P, Haque Z, O'Leary S, Cahill J. Propionibacterium acnes in brain biopsy specimens in suspected neurosarcoidosis: A case presentation and review of the literature. Neuroimmunology Reports. 2022;2(2022):100135. doi:10.1016/j.nerep.2022.100135