Abstract
Introduction. The Propionibacterium acnes and the Staphylococcus cohnii ssp. cohnii are occasional pathogenic bacteria. The intrascrotal localization of the Propionibacterium acnes is exceptional. The Staphylococcus cohnii ssp. cohnii is not able to colonize the urogenital apparatus but it is the most frequently responsible for blood culture contamination even if it can sustain, in particular conditions, systemic infections. Case Presentation. We report the case of a 72-year-old man who is under observation for pain and swelling of the left hemiscrotum associated to high fever. The scrotal ultrasound shows the presence of a left intra-scrotal abscess with didymus, epididymis, and intact didymus-epididymis tunicae. The blood culture executed for evening fever during antibiotic therapy has underlined an infection with Propionibacterium acnes. A following blood culture has shown an increase in Staphylococcus cohnii ssp. cohnii. Due to fever the patient has undergone left orchifunicolectomy with inguino-scrotal toilet. The anatomical pathological examination has also shown the presence of nonspecific granulomatous inflammation compatible with Propionibacterium acnes infection. Conclusion. The onset of an intrascrotal abscess likely sustained by Propionibacterium acnes complicated by a possible systemic Staphylococcus cohnii ssp. cohnii suprainfection is an exceptional event that, in our case, has been resolved with surgical toilet.
Highlights
The Propionibacterium acnes and the Staphylococcus cohnii ssp. cohnii are occasional pathogenic bacteria
We report a case of intra-scrotal abscess likely sustained by P. acnes, complicated by a probable systemic supra-infection due to S. cohnii
We analyse the report of the first blood culture examination executed 4 days after the blood collection that highlights a P. acnes infection in 2 of the 3 samples taken in absence of antibiogram
Summary
Both the Propionibacterium acnes (P. acnes) and the Staphylococcus cohnii ssp. cohnii (S. cohnii) are bacteria that constitute part of the normal skin commensal flora and of the human mucous membranes that can, especially in particular conditions, behave like opportunistic pathogenic bacteria [1, 2]. Both the Propionibacterium acnes (P. acnes) and the Staphylococcus cohnii ssp. Cohnii (S. cohnii) are bacteria that constitute part of the normal skin commensal flora and of the human mucous membranes that can, especially in particular conditions, behave like opportunistic pathogenic bacteria [1, 2]. The intra-scrotal infections are sustained exceptionally by P. acnes. The S. cohnii, according to the data present in literature, has not been related so far to infections of the urogenital apparatus. We report a case of intra-scrotal abscess likely sustained by P. acnes, complicated by a probable systemic supra-infection due to S. cohnii
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