Propionibacterium Acnes Prosthetic Valve Endocarditis Caused by Unsuitable Leg Shaving. Importance of Specific Recommendations to Reduce Prosthetic Contamination

Propionibacterium Acnes Prosthetic Valve Endocarditis Caused by Unsuitable Leg Shaving. Importance of Specific Recommendations to Reduce Prosthetic ContaminationIntroduction: Propionibaterium acnes (PA) is a bacteria associated with Acnes vulgaris and considered to have a low level of virulence. However, it has been involved in rare cases of prosthetic valve endocarditis whose diagnosis remains difficult. The origin of the prosthetic valve contamination is usually unclear. Extensive tissular damages characterize PA endocarditis. Methods and Results: We report the rare case of a PA contamination of an aortic mechanical valved conduit that required an urgent and complex stepwise surgical procedure. Investigations ascertained a highly probable source of contamination caused by leg shaving with manual razors necessitating specific dermatologic recommendations for patients with a valvular prosthesis. Conclusions: This unusual clinical presentation provided the opportunity to review the literature and characterize microbiological and clinical specificities of PA prosthetic valve endocarditis with the absolute necessity of urgent withdrawal of the prosthetic valvular material and dermatologic recommendations.