title: Pacemaker endocarditis caused by Propionibacterium acnes in an adult patient with Ebstein's anomaly: a report of a rare case.
abstract: We report a rare case of a Brazilian adult woman with Ebstein's Anomaly who presented with pacemaker endocarditis caused by Propionibacterium acnes. Ebstein's Anomaly is a rare congenital malformation of the heart. Infective endocarditis is defined as an infection of heart valves, of the mural endocardium, of a septal defect, or of a cardiac electronic implantable device. Propionibacterium acnes is a skin commensal bacterium, that is usually considered as a contaminant, but can, on rare occasions, cause serious infections including endocarditis of prosthetic valves, native valves and cardiac electronic implantable devices. Diagnosis was made after nearly two years of investigation by identification of the organism by the MALDI-TOF technique and transoesophageal echocardiogram. The patient was successfully treated with daptomycin and device removal. She remains free of endocarditis after 32 months of follow-up.
authors.affiliation: Department of Myocardium, Pericardium and Aorta Diseases, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil. Electronic address: karlasanto@gmail.com.
authors.forename: Karla R E
authors.initials: KR
authors.lastname: Santo
authors.affiliation: Department of Myocardium, Pericardium and Aorta Diseases, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
authors.forename: Vinicius
authors.initials: V
authors.lastname: Franceschi
authors.affiliation: Department of Myocardium, Pericardium and Aorta Diseases, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
authors.forename: André C B
authors.initials: AC
authors.lastname: Campos
authors.affiliation: Department of Myocardium, Pericardium and Aorta Diseases, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
authors.forename: Thaíssa S
authors.initials: TS
authors.lastname: Monteiro
authors.affiliation: Department of Infection Control, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
authors.forename: Giovanna I F
authors.initials: GI
authors.lastname: Barbosa
authors.affiliation: Department of Microbiology, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
authors.forename: Angela
authors.initials: A
authors.lastname: Dantas
authors.affiliation: Department of Infection Control, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil; Senior Lecturer, Unigranrio, Rio de Janeiro, Brazil; Infectious Diseases Inpatient Unit, Instituto de Pesquisa Clínica Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil.
authors.forename: Cristiane C
authors.initials: CC
authors.lastname: Lamas
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D020878:Device Removal; D004437:Ebstein Anomaly / Q000150:complications*; D004567:Electrodes, Implanted / Q000009:adverse effects* / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011425:Propionibacterium acnes / Q000302:isolation & purification*; D012008:Recurrence
chemical_list: D000900:Anti-Bacterial Agents
keywords: Ebstein's Anomaly; Infective endocarditis; MALDI-TOF technique; Pacemaker; Propionibacterium acnes