Bacterial
pericarditis is a critical diagnosis caused by a wide range of organisms including Streptococcus pneumoniae and other anaerobic organisms like Cutibacterium acnes which has been gaining more importance as a causative organism. Cutibacterium species are Gram-positive microaerophilic rods that constitute part of the normal flora of skin and mucosal membranes. The incidence of
pericarditis caused by this organism is underreported as it is often dismissed as a skin flora contaminant. However, if left untreated, Cutibacterium acnes can cause
pericarditis with serious complications. In this paper, we present a comprehensive review of the literature regarding
pericarditis caused by Cutibacterium acnes along with a case presentation from our institution. In our institution, a 20-year-old man with history of
atrial septal defect presented with
chest pain radiating to the back along with symptoms of
upper respiratory tract infection including
headaches and
myalgia. Electrocardiogram was remarkable for diffuse low-voltage waves. Echocardiography revealed a large
pericardial effusion with tamponade features. Pericardiocentesis drained 1.2 L of milky fluid. Pericardial fluid analysis grew Cutibacterium acnes after being cultured for 8 days. The patient received 3 weeks of IV
penicillin followed by 3 weeks of oral
amoxicillin along with
nonsteroidal anti-inflammatory agents and
colchicine with no recurrence.
Pericarditis caused by Cutibacterium acnes requires a high clinical suspicion since isolation of this organism can be dismissed as a skin flora contaminant. Literature review reveals that this
infection may be underdiagnosed and underreported. Prompt diagnosis may lead to timely initiation of
antibiotics which can help prevent devastating complications like
constrictive pericarditis. Prospective studies are needed to evaluate the true incidence and prevalence of this disease.