Unusual Acute Onset of Abdominal Aortic Endograft Infection by Propionibacterium acnes after Coil Embolization for Type II Endoleak.

Propionibacterium acnes, an anaerobic gram-positive bacillus that inhabits the skin, has rarely been incriminated in abdominal aortic endograft infection. It is usually responsible for typical delayed and low-grade postoperative infections. We report the case of a 66-year-old patient who developed acute P. acnes aortic stent-graft infection 9 days after percutaneous embolization for type II endoleak. The stent graft had been implanted 2 years before. Because of persistent signs of sepsis and discovery of a posterior periaortic abscess formation on the computed tomography scan, removal of the stent graft was necessary. Despite being described as a low virulence and slow growth bacteria, P. acnes was responsible for acute onset of postoperative infection with extensive life-threatening damages necessitating multiple interventions associated with long-term antibiotherapy.