traps and tricks about a 6-years old cutibacterium endocarditis

Endocarditis of cardiac implanted electronic devices is a complex and serious disease. commensal bacteria of the skin are commonly considered as contamination of blood culture. herein, the authors report the case of a pacemaker endocarditis with cultures positive for cutibacterium acnes. these were already found 3 and 6 years ago but not observed during hospitalisation. the pet-scan was of great help in guiding the diagnosis. the management was particularly difficult with 9 leads to extract. a sequential approach in the operating room from endovascular procedure to surgery under cardio-pulmonary bypass was used. a second procedure was necessary to extract a small forgotten foreign body already visible on the preoperative chest x-ray. this experience shows the importance of having a high level of suspicion in case of culture positive for cutibacterium with intracardiac devices, and of looking for foreign bodies on the preoperative chest x-ray in case of a history of multiple rhythmological procedures.