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Published on: September 24, 2021

Mycotic pulmonary artery aneurysm as a late complication of infective endocarditis after pacemaker implantation

Tsukasa Saida1, Hiroki Ninomiya, Motoshige Yamasaki

  • 1Department of Diagnostic Radiology and Interventional Radiology, Tsukuba University Hospital, 2-1-1 Amakubo, Tsukuba, 305-8558, Japan. tsukasas@dia-net.ne.jp

Radiation Medicine
|June 22, 2007
PubMed

Insights

A pacemaker infection led to a rapidly growing pulmonary artery aneurysm in a woman. Prompt removal of the pacemaker and antibiotic treatment successfully managed the mycotic aneurysm, preventing rupture.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Pacemaker implantation is a common procedure for cardiac rhythm management.
  • Infections associated with implanted cardiac devices can lead to serious complications.
  • Mycotic aneurysms, particularly in the pulmonary artery, are rare but life-threatening conditions.

Observation:

  • A 49-year-old woman presented with acute illness, high fever, and fatigue 15 years after pacemaker implantation.
  • Rapid development of a pulmonary artery aneurysm occurred within two weeks.
  • The patient experienced symptoms suggestive of an infectious process linked to the pacemaker.

Findings:

  • Removal of the pacemaker and initiation of antibiotic therapy led to a gradual decrease in aneurysm size.
  • The mycotic aneurysm remained unruptured for a 3-year follow-up period.
  • Conservative management, including antibiotics and device removal, proved effective.

Implications:

  • This case highlights the potential for late-onset pacemaker-related infections causing mycotic aneurysms.
  • Early detection and intervention, including device explantation and antibiotics, are crucial for managing such cases.
  • Conservative treatment may be sufficient for mycotic pulmonary artery aneurysms in select patients, avoiding more invasive surgical options.

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