Propionibacterium acnes prosthetic valve endocarditis: A case of severe aortic insufficiency

Summary: Propionibacterium acnes rarely causes sys- temic disease. Few cases of l? acnes endocarditis have been reported. This report describes a 63-year-old man who presented with severe congestive heart failure. He had prosthetic valve endocarditis which resulted in severe acute aortic insufficiency. During surgery he was found to have complete disruption of the aorta and left ventricle with a false aneurysm encompassing the circumference of the aortic annulus. Cultures of the valve grew l? acnes. Thus, although l? acnes is a rare cause of endocarditis, it may pursue a very aggressive course, especially in the set- ting of a prosthetic valve. Key words: endocarditis, aortic insufficiency, false aneurysm Introduction Propionibacterium acnes is a gram-positive anaerobic diphtheroid found on the skin. This organism rarely is as- sociated with systemic disease. There are several reports of endocarditis secondary to l? acnes.'" We report a case of l? acnes endocarditis which followed a very aggressive course and was associated with unusual pathologic find- ings.