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[Febrile myalgia revealing Propionibacterium acnes endocarditis]
M Garric1, X Boumaza1, K Paricaud1
1Service de médecine Interne, CHU Toulouse-Purpan, Toulouse, France.
La Revue De Medecine Interne
|June 24, 2019
Summary
Propionibacterium acnes endocarditis, though rare, can manifest as lower limb fasciitis in patients with vascular prostheses. Prolonged blood cultures are crucial for diagnosing this challenging infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Surgery
Background:
- Propionibacterium acnes endocarditis is a rare and diagnostically challenging condition.
- Infective endocarditis often involves prosthetic valves, but atypical presentations are increasingly recognized.
Observation:
- A 54-year-old patient with a history of aortic surgery developed recurrent lower limb myalgia and fasciitis.
- Imaging revealed fasciitis and increased 18-Fluorodeoxyglucose uptake in the aortic prosthesis and lower limb muscles.
- Blood cultures, after prolonged incubation, identified Propionibacterium acnes.
Findings:
- The patient was diagnosed with infective endocarditis caused by Propionibacterium acnes, revealed by lower limb emboli.
- Surgical removal of the infected aortic prosthesis led to a favorable outcome.
Implications:
- Propionibacterium acnes should be considered in patients with vascular prostheses presenting with unusual inflammatory conditions.
- Extended blood culture incubation periods are essential for identifying Propionibacterium acnes in suspected cases of prosthetic valve endocarditis.
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