A sixty-five-year-old immunocompetent man with bilateral osteonecrosis of the hip and no prior surgical procedures or trauma was found to have a subacute Propionibacterium acnes infection of the femoral head. To our knowledge, this is the first reported case of Propionibacterium acnes infection in a native hip in the orthopaedic literature.
Diagnosing a subacute P. acnes infection can be challenging because of nonspecific clinical findings, normal laboratory values, and delayed growth of this organism on culture. Clinicians should maintain a high degree of suspicion as these infections are frequently missed.
1Department of Orthopaedic Surgery, Keck Hospital of USC, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, Los Angeles, CA 90033. E-mail address for J. R. Lieberman: email@example.com