title: Valve Dehiscence after Bentall Procedure: The Detrimental Traits of Propionibacterium.
abstract: The present case exemplified the detrimental traits of prosthetic valve endocarditis caused by Propionibacterium acnes. As a baby, the patient had a congenital cardiac defect with truncus arteriosus type I with interrupted aortic arch and open ductus Botalli, and had undergone several operations. However, at 18 months after a Bentall procedure performed 29 years later he presented with major prosthetic dehiscence due to endocarditis. The patient underwent a high-risk reoperation for a re-do Bentall procedure and was treated postoperatively with intravenous antibiotics consisting of vancomycin for five weeks and penicillin and rifampicin each for six weeks. He was discharged from hospital in good clinical condition. In conclusion, P. acnes-mediated endocarditis of a prosthetic valve can be successfully treated with prompt surgery and antibiotic therapy.
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.|Department of Cardio-Thoracic Surgery, Leiden University Medical Center, Leiden, the Netherlands. Electronic correspondence: R.A.F.de_Lind_van_Wijngaarden@lumc.nl.
authors.forename: Robert A
authors.initials: RA
authors.lastname: F de Lind van Wijngaarden
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: van Valen
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Jos A
authors.initials: JA
authors.lastname: Bekkers
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Ad J
authors.initials: AJ
authors.lastname: J C Bogers
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011425:Propionibacterium acnes; D016459:Prosthesis-Related Infections / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D012086:Reoperation
chemical_list: D000900:Anti-Bacterial Agents