Cutibacterium (formerly Propionibacterium) acnes clavicular infection

<p class="p p-first-last" id="__p2"><em>Cutibacterium</em> (formerly <em>Propionibacterium</em>)<em> acnes^{13, 16}</em> is a slow growing, gram-positive bacteria that is naturally found in higher concentrations as skin flora on the chest and back, as well as in other areas with greater numbers of hair follicles.^{25, 37} Most of the reported cases of <em>C. acnes</em> shoulder girdle infection follow arthroplasty surgery,^{18, 20, 26, 27, 32, 35} which then often requires debridement, administration of intravenous antibiotics, and surgical revision of the implanted device.^{12, 15, 21, 28-30} In a recent study, 56% of 193 shoulder revisions had a positive culture, 70% of which grew <em>C. acnes</em>.³⁰ Despite the relatively common presumed association of <em>C. acnes</em> humeral osteomyelitis with prosthetic infection, infection of the scapula or clavicle secondary to <em>C. acnes</em> is rare.^{4, 23, 36} Osteomyelitis of the clavicle involving any organism is also an uncommon event that can arise spontaneously via presumed hematogenous spread, or secondary to open fractures or internal fixation.^{6, 33} The most commonly found organism in clavicular osteomyelitis is <em>Staphylococcus aureus</em>.⁹ We here report two cases of clavicular infection secondary to <em>C. acnes</em> that were not associated with implants.</p>

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