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Pacemaker lead endocarditis caused by Achromobacter xylosoxidans.
Youngkeun Ahn1, Nam Ho Kim, Dong Hyeon Shin
1Division of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
Journal of Korean Medical Science
|April 15, 2004
Summary
A pacemaker lead infection caused by Achromobacter xylosoxidans led to endocarditis in a 35-year-old patient. Prompt removal of the pacing system and antibiotics are crucial for effective treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Device Infections
Background:
- A 35-year-old patient with a history of ventricular septal defect repair and multiple pacemaker implantations presented with fever and chills.
- The patient had a history of complete heart block requiring VVI pacemaker implantation, with a subsequent lead replacement.
Observation:
- Echocardiography revealed pacemaker lead adherence with hyperechoic materials and a mobile, stalked mass in the right ventricle outflow tract.
- Blood and pus cultures from the pacemaker lead identified Achromobacter xylosoxidans.
Findings:
- The patient was diagnosed with pacemaker lead endocarditis attributed to Achromobacter xylosoxidans infection.
- The presence of a vegetation on the pacemaker lead confirmed the diagnosis.
Implications:
- This case highlights the risk of pacemaker lead endocarditis, even with multiple lead interventions.
- Immediate removal of the infected pacing system combined with targeted antimicrobial therapy is essential for successful management.
- Early diagnosis and intervention are critical to prevent complications associated with cardiac device infections.