Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 8 5 2024 03 13 203 207 Calixte de La BOURDONNAYE Centre Hospitalier Régional, Site Félix Guyon, Service De Chirurgie Cardiaque, Allée Des Topazes, 97400 Saint Denis, Bellespierres, La Réunion, France Bertille le Chevallier Centre Hospitalier Régional, Site Félix Guyon, Service De Chirurgie Cardiaque, Allée Des Topazes, 97400 Saint Denis, Bellespierres, La Réunion, France Fatma Mhiri Centre Hospitalier Régional, Site Félix Guyon, Service De Chirurgie Cardiaque, Allée Des Topazes, 97400 Saint Denis, Bellespierres, La Réunion, France Eric Braunberger Centre Hospitalier Régional, Site Félix Guyon, Service De Chirurgie Cardiaque, Allée Des Topazes, 97400 Saint Denis, Bellespierres, La Réunion, France 2023 05 11 2024 01 27 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. https://crcp.tums.ac.ir/index.php/crcp/article/view/827