[Successfully Treated Rapidly Progressive Prosthetic Valve Endocarditis Caused by Cutibacterium Species:Report of a Case].

Abstract

A 75-year-old man with a history of aortic valve replacement was referred to our department with a diagnosis of prosthetic valve endocarditis. Although antibiotics treatment was initiated, infection progressed rapidly to develop aortic root abscess and pseudoaneurysm. The patient underwent urgent surgery which included extensive debridement of near-circumferential infected annulus. Aortic annulus reconstruction with a bovine pericardial patch was performed followed by aortic valve replacement. The postoperative course was uneventful and the patient was discharged from the hospital after six weeks of intravenous antibiotic therapy. The causative bacteria were identified as Cutibacterium species by 16S ribosomal deoxyribonucleic acid( rDNA) sequencing, following 56 days of blood sample incubation collection. Due to slow growth of the pathogen, endocarditis by Cutibacterium species is known for gradual progression and difficulty in pathogen identification. The present case highlights that endocarditis by Cutibacterium may cause rapid progression with extensive tissue destruction. 16S rDNA sequencing was useful in identifying the pathogen. Extensive debridement and reconstruction of the aortic annulus with a bovine pericardium a successfully salvaged the patient.