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Propionibacterium acnes endocarditis on an annuloplasty ring in an adolescent boy
W Y Vanagt1, W J Daenen, T Delhaas
1Department of Paediatrics, University Hospital Maastricht, PO box 5800, 6202 AZ Maastricht, Netherlands. ward.vanagt@fys.unimaas.nl
Heart (British Cardiac Society)
|August 18, 2004
Abstract:
Propionibacterium acnes, a constituent of the human cutaneous flora, infected both the native mitral valve and a Carpentier mitral annuloplasty ring in an adolescent patient. In the case of culture negative endocarditis, the incubation period of blood cultures should be prolonged to identify this pathogen.
Insights
Propionibacterium acnes, a common skin bacterium, can cause serious heart infections, even in patients with prosthetic devices. Prolonged blood culture incubation is crucial for diagnosing culture-negative endocarditis caused by this pathogen.
Area of Science:
- Cardiology
- Infectious Diseases
- Microbiology
Background:
- Propionibacterium acnes is a commensal bacterium of human skin.
- Infective endocarditis is a serious infection of the heart valves.
- Prosthetic cardiac devices can be susceptible to infection.
Observation:
- A case of infective endocarditis in an adolescent patient is presented.
- The infection involved both the native mitral valve and a Carpentier mitral annuloplasty ring.
- Propionibacterium acnes was identified as the causative agent.
Findings:
- Propionibacterium acnes can infect native heart valves and prosthetic cardiac materials.
- This pathogen can lead to culture-negative endocarditis if blood cultures are not incubated sufficiently long.
- Extended incubation periods for blood cultures are essential for identifying Propionibacterium acnes in suspected endocarditis cases.
Implications:
- Clinicians should consider Propionibacterium acnes in the differential diagnosis of culture-negative endocarditis.
- Prolonging blood culture incubation may improve the diagnostic yield for challenging pathogens like Propionibacterium acnes.
- This case highlights the importance of considering skin flora in prosthetic device infections.
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