Propionibacterium acnes prosthetic valve endocarditis: a case of severe aortic insufficiency.

Propionibacterium acnes rarely causes systemic disease. Few cases of P. 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 P. acnes. Thus, although P. acnes is a rare cause of endocarditis, it may pursue a very aggressive course, especially in the setting of a prosthetic valve.