Why the study?
Purulent pericarditis carries high mortality if untreated, and Cutibacterium acnes, though usually considered a culture contaminant, has pathogenic potential.
This case demonstrates that purulent pericarditis with cardiac tamponade caused by C. acnes can be successfully treated with a 14-day course of vancomycin in a patient with severe penicillin allergy.
May support vancomycin in penicillin-allergic patients with C. acnes pericarditis; leaves open need for prospective validation.
Purulent pericarditis is a potentially fatal disease with high mortality rates if untreated. Cutibacterium acnes (formerly Propionibacterium acnes) is an anaerobic bacteria that is ubiquitous in skin flora and is commonly thought of as a culture contaminant; however, it does have pathogenic potential. We present a case of purulent pericarditis secondary to C. acnes leading to cardiac tamponade. Initial stabilization and diagnosis were made via pericardiocentesis; afterward the patient underwent a pericardial window. Due to a severe penicillin allergy, he was successfully treated with a 14-day course of vancomycin. To our knowledge, this represents only the third published case of purulent pericarditis with cardiac tamponade caused by C. acnes and the first case treated with a 14-day course of vancomycin.
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Farhat-Sabet et al. (2018) studied this question.
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