Which Cutibacterium (Propionibacterium) infections cause endocarditis?

Updated: Dec 03, 2019
  • Author: Sajeev Handa, MBBCh, BAO, LRCSI, LRCPI; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

Cutibacterium species are an underrecognized cause of endocarditis and, as noted above, have been associated with both native and prosthetic valves. The indolent nature of the organism results in cases typically associated with a relatively long history with minimal clinical signs of infection at initial presentation.

In the review performed by Clayton et al, fever was noted to be the most common presenting complaint (81.8%), followed by lethargy and malaise (42.4%) and sweats and chills (27.2%). There was a paucity of examination findings, limited to a murmur reported in 45.4% of cases, and only 12.1% of the cases had the classical stigmata of infective endocarditis (eg, Osler nodes, Janeway lesions, splinter hemorrhages, macular hemorrhages).

Complications may be serious, with the development of intracardiac abscesses [4] and CNS emboli, congestive cardiac failure, cardiac abscesses, and valve dehiscence. [7]

C acnes is the most frequently implicated, but rarely is C granulosum implicated. [8]

C acnes cardiovascular device–related infections typically have a subtle presentation that can include low-grade fever, weight loss, malaise, and myalgias.


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