A case of decreased visual acuity due to local ethmoid sinusitis caused by Propionibacterium acnes

Abstract

Propionibacterium acnes (P. acnes) is gram-positive bacilli known as a cause of acne vulgaris. As P. acnes is less toxic, it rarely causes acute destructive infection. We report the case of 70-year-old man suffering from decreased visual acuity in his right eye due to local ethmoid sinusitis caused by P. acnes. He was admitted to our hospital because of decreased visual acuity in his right eye. Computed tomography showed inflammation in the right orbital apex from the ethmoid sinusitis. We performed endoscopic sinus surgery and P. acnes was detected in a pus culture from the right ethmoid sinus. We therefore diagnosed that the causative microorganism of his sinusitis was P. acnes. Optic neuropathy due to ethmoid sinusitis caused by P. acnes is very rare, and prompt surgery and antibiotic treatment are necessary for a compromised host.