[Postoperative intra-abdominal abscess with bacteremia due to Propionibacterium acnes]

Delayed perihepatic abscess caused by Cutibacterium acnes following right partial hepatectomy

We describe a case of a man in his 70s who presented with tachycardia and several weeks of right lower quadrant pain 3 months after partial right hepatectomy for hepatocellular carcinoma. Initial laboratory findings were significant for elevated C reactive protein and normal white cell count. CT revealed right pleural effusion and 5.8 cm fluid collection with air pocket adjacent to the surgical margin of the partial hepatectomy. Aspirate of the fluid collection grew Cutibacterium acnes Following percutaneous drainage and a short course of antibiotics, the patient recovered with eventual radiologic and symptomatic improvement. This, to the best of our knowledge, is one of two cases where C. acnes was involved in a possible delayed presentation of a surgical site infection after hepatic surgery.