Prosthetic valve endocarditis due toPropionibacterium acnes

Abstract

Propionibacterium acnes PVE is a rare complication after valve surgery. Redo surgery is often required. Treatment of the dysfunctional prosthetic aortic valve most often consists of root replacement, in combination with antibiotic therapy.

Silent Native-valve Endocarditis Caused by <i>Propionibacterium acnes</i>

“…Due to the limited number of cases, an appropriate antibiotic therapy has yet established. However, most previous cases of P. acnes PVE have been treated with penicillin in combination with rifampicin or gentamicin ( 6 , 22 , 23 ). Penicillin-resistant Propionibacterium isolates are extremely rare; however, one such IE case has been described ( 24 ).…”

“…Daptomycin combined with rifampicin is also a treatment of choice for biofilm-associated infection ( 23 ). Six weeks of treatment appears to be sufficient for P. acnes PVE ( 5 , 6 , 13 ). Surgical resection is required in most cases of P. acnes PVE; however, conservative treatment was shown to be successful in a few cases ( 25 ).…”

“…In a case series of 58 patients with Propionibacterium endocarditis, 79% of the patients had prosthetic cardiac devices ( 5 ). One of two recent single-centered retrospective studies reported that all 13 cases of P. acnes endocarditis occurred in patients after valve replacement surgery ( 6 ); the other reported that 23 of 24 cases (95.8%) involved either a prosthetic valve or annuloplasty ring ( 7 ). In addition, the most recent multi-center study in Spain reported that P. acnes accounted for only 14 of approximately 2,500 (0.56%) IE cases, of which 12 (85.7%) cases occurred in patients with prosthetic devices ( 8 ).…”

Acute Peritonitis Caused by Propionibacterium Acnes in a Peritoneal Dialysis Patient

“…P. acnes has been associated with focal intracranial infections [2], infections of the cerebrospinal fluid shunt [3], corneal infections [4], endophthalmitis [5], endocarditis of both prosthetic [6] and native aortic valves [7]. It has also been identified as a cause of several orthopedic, silicone breast prosthesis, and prosthetic joint infections [8][9][10].…”

Man in his 50s with chest pain and dyspnoea

“…P. acnes is reported to cause life-threatening endocarditis with prosthetic valve embolisation 2. The characteristic that P. acnes is a slow-growing and low-virulence bacterium results in the delay of diagnosis 3. In case of sudden cardiogenic shock in patients with prosthetic valve, complete embolisation of the valve should be considered as a differential diagnosis, and immediate recognition of this critical condition is essential.…”