Cutibacterium acnes Brodie's abscess of the proximal tibia: A case report

Introduction

Brodie’s abscess, a subacute osteomyelitis, is characterized by a well-demarcated collection of purulence within the bone. It presents with nonspecific signs and symptoms. Diagnosing Brodie's abscess typically involves MRI, which is superior to conventional X-rays. It can be mistaken for osteoid osteoma, Langerhans cell histiocytosis, chondrosarcoma, eosinophilic granuloma, or tuberculosis. Staphylococcus aureus is the most common organism involved.

Case Presentation

We present a unique case of Brodie’s abscess within the proximal tibia secondary to Cutibacterium acnes, an unusual pathogen in Brodie’s Abscess, in a setting of previous right tibial shaft fracture with external fixation complicated by pin-site tract infection after many years.

Discussion

Traditionally viewed as a nonpathogenic contaminant due to its association with normal skin flora, C. acnes is often underdiagnosed and underreported in other infections due to inadequate culture media and subtle clinical symptoms. Treatment of Brodie’s abscess generally involves surgical debridement followed by antibiotics, though the optimal antibiotic regimen is unclear.

Conclusion

Further research is needed regarding atypical presentations of C. acnes such as our case.