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Recurrent Cutibacterium acnes prosthetic valve endocarditis
  1. Ahmed Ashraf Abdelhamid,
  2. Takaaki Kobayashi,
  3. Joseph Tholany and
  4. Poorani Sekar
  1. Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  1. Correspondence to Dr Ahmed Ashraf Abdelhamid; ahmed-abdelhamid{at}


A 29-year-old man with a history of congenital aortic stenosis and mechanical aortic valve replacement with previous Cutibacterium acnes prosthetic valve endocarditis (PVE) presented with a 2-week history of fevers and night sweats. Transoesophageal echocardiogram revealed a 0.6 cm×0.5 cm vegetation on the mechanical aortic valve. An anaerobic blood culture became positive for C. acnes 6 days after the blood cultures were obtained. He did not have any surgical intervention. He was successfully treated with 6 weeks of ceftriaxone, followed by chronic suppression with oral doxycycline. Despite its low virulence, a growing number of C. acnes PVE cases have been reported, owing to its biofilm production. When clinical suspicion is high, extending culture incubation duration beyond the standard 5 days might be helpful. Most cases are treated with surgical repair or replacement in conjunction with antibiotics, but medical therapy alone has been documented as being successful.

  • infectious diseases
  • valvar diseases
  • cardiovascular medicine

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  • Contributors AAA wrote the first draft of the manuscript. PS, TK and JT critically reviewed and revised the manuscript. All the authors read and approved the final paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.