Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis

In this case report we share a case of infective Pericarditis caused by Propionibacterium acnes (P. acnes) in an immune-competent, nonsurgical patient. This case and review will illustrate the importance of considering P. acnes as a cause of idiopathic pericardial effusion and effusive constrictive...

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Main Authors: Daniel Cruz, Haitham Ahmed, Yousuf Gandapur, M. Roselle Abraham
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2015/193272
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author Daniel Cruz
Haitham Ahmed
Yousuf Gandapur
M. Roselle Abraham
author_facet Daniel Cruz
Haitham Ahmed
Yousuf Gandapur
M. Roselle Abraham
author_sort Daniel Cruz
collection DOAJ
description In this case report we share a case of infective Pericarditis caused by Propionibacterium acnes (P. acnes) in an immune-competent, nonsurgical patient. This case and review will illustrate the importance of considering P. acnes as a cause of idiopathic pericardial effusion and effusive constrictive disease. The patient was a 61-year-old male with history of osteoarthritis of the knee. He received an intra-articular steroid injection in July 2013. Two months later, he presented with atrial fibrillation and heart failure. He was found to have pericardial and bilateral pleural effusions which grew P. acnes. This organism was initially considered to be contaminant; however, as P. acnes was isolated from both pleural and pericardial fluids, he was started on oral amoxicillin. He was noted to have recurrence of effusions within 2 weeks with evidence of constrictive physiology by echocardiography. Treatment was subsequently changed to intravenous Penicillin G with marked symptomatic improvement, resolution of pericardial/pleural effusions, and no echocardiographic evidence of constrictive pericarditis at 10 weeks follow-up. Pursuit and treatment of P. acnes could lead to prevention of constrictive pericarditis. We believe that further studies are needed to assess prevalence of P. acnes and response to intravenous Penicillin G in patients presenting with effusive constrictive disease.
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spelling doaj-art-d48958150fbd4526a381d2243e8621062025-02-03T01:31:28ZengWileyCase Reports in Medicine1687-96271687-96352015-01-01201510.1155/2015/193272193272Propionibacterium acnes: A Treatable Cause of Constrictive PericarditisDaniel Cruz0Haitham Ahmed1Yousuf Gandapur2M. Roselle Abraham3Osler Medical Service, Johns Hopkins School of Medicine, Baltimore, MD 21287, USADivision of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USADepartment of Medicine, Good Samaritan Hospital, Baltimore, MD 21239, USADivision of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USAIn this case report we share a case of infective Pericarditis caused by Propionibacterium acnes (P. acnes) in an immune-competent, nonsurgical patient. This case and review will illustrate the importance of considering P. acnes as a cause of idiopathic pericardial effusion and effusive constrictive disease. The patient was a 61-year-old male with history of osteoarthritis of the knee. He received an intra-articular steroid injection in July 2013. Two months later, he presented with atrial fibrillation and heart failure. He was found to have pericardial and bilateral pleural effusions which grew P. acnes. This organism was initially considered to be contaminant; however, as P. acnes was isolated from both pleural and pericardial fluids, he was started on oral amoxicillin. He was noted to have recurrence of effusions within 2 weeks with evidence of constrictive physiology by echocardiography. Treatment was subsequently changed to intravenous Penicillin G with marked symptomatic improvement, resolution of pericardial/pleural effusions, and no echocardiographic evidence of constrictive pericarditis at 10 weeks follow-up. Pursuit and treatment of P. acnes could lead to prevention of constrictive pericarditis. We believe that further studies are needed to assess prevalence of P. acnes and response to intravenous Penicillin G in patients presenting with effusive constrictive disease.http://dx.doi.org/10.1155/2015/193272
spellingShingle Daniel Cruz
Haitham Ahmed
Yousuf Gandapur
M. Roselle Abraham
Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis
Case Reports in Medicine
title Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis
title_full Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis
title_fullStr Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis
title_full_unstemmed Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis
title_short Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis
title_sort propionibacterium acnes a treatable cause of constrictive pericarditis
url http://dx.doi.org/10.1155/2015/193272
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