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[Propionibacterium acnes infectious endocarditis]
S Durupt1, A Boibieux, M Ballet-Mechain
1Service des Maladies infectieuses, Hôpital de la Croix Rousse, Lyon.
Background:
Propionibacterium acnes, a Gram positive microaerophilic bacteria is considered to have a low level of virulence. Nevertheless, it can be associated with infective endocarditis. We report 2 cases and a review of the literature.
Case Reports:
The first man developed an acute prosthetic valve infective endocarditis and died. The second case was also a prosthetic valve infective endocarditis in a patient who developed infectious spondylitis.
Discussion:
P. acnes is an uncommon causal agent in infective endocarditis and appears to have a predilectio for prosthetic valves. A prior history of skin infection is rare. P. acnes grow quite slowly, often requiring 7 to 14 days for identification. All isolates of P. acnes from blood or valve do not necessarily mean contamination.
Insights
Propionibacterium acnes (P. acnes) can cause infective endocarditis, particularly in prosthetic valves. Slow bacterial growth necessitates careful interpretation of positive blood cultures to avoid misidentification as contamination.
Area of Science:
- Microbiology
- Infectious Diseases
- Cardiology
Background:
- Propionibacterium acnes (P. acnes), a Gram-positive bacterium, is generally considered to have low virulence.
- Despite its low virulence, P. acnes has been implicated in rare cases of infective endocarditis.
Observation:
- Two cases of prosthetic valve infective endocarditis caused by P. acnes are presented.
- One patient developed acute prosthetic valve endocarditis and died, while the second experienced infectious spondylitis.
Findings:
- P. acnes is an infrequent cause of infective endocarditis, with a tendency to affect prosthetic valves.
- Skin infection history is uncommon in P. acnes endocarditis cases.
- P. acnes exhibits slow growth, requiring 7-14 days for identification, complicating diagnosis.
Implications:
- Positive blood or valve cultures for P. acnes should be interpreted cautiously, considering its slow growth and potential for contamination.
- The findings highlight the importance of considering P. acnes in the differential diagnosis of endocarditis, especially in patients with prosthetic valves.