Infective endocarditis: acne to zoonoses on the valve, an A to Z perspective

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Cutibacterium acnes (C. acnes), formerly Propionibacterium acnes, is an uncommon pathogen implicated in infective endocarditis (IE).
• IE caused by C. acnes presents unique diagnostic and management challenges due to its rarity and often indolent clinical course.
• Limited specific guidelines exist for managing C. acnes IE, necessitating further clinical insights.

Purpose of the Study:

• To review the literature and present two single-center cases of C. acnes IE.
• To elucidate the diverse clinical presentations, disease progression, and management strategies for C. acnes IE.
• To emphasize diagnostic challenges and advocate for improved diagnostic accuracy and timely treatment initiation.

Main Methods:

• Comprehensive literature review on C. acnes infective endocarditis.
• Retrospective analysis of two patient cases from a single tertiary care center.
• Clinical data compilation focusing on presentation, diagnostic workup, treatment, and outcomes.

Main Results:

• C. acnes IE cases often exhibit subtle or delayed presentation, complicating initial diagnosis.
• The disease course can be indolent, with symptoms developing gradually over time.
• Management requires a multidisciplinary approach, often involving prolonged antibiotic therapy and surgical intervention.

Conclusions:

• Improved awareness and diagnostic vigilance are crucial for timely identification of C. acnes IE.
• Further research is needed to establish specific management guidelines for this rare condition.
• Understanding the indolent nature of C. acnes IE is key to optimizing patient care and prognosis.