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[Septic pulmonary embolism, bacterial endocarditis and endocavitary pacemaker].
J Gil1, J M Arriero, F García de Burgos
1Seccione de Neumología, Hospital de Elche, Alicante.
Revista Clinica Espanola
|March 1, 1991
Summary
Endocarditic pacemaker thrombosis, often caused by Proteus mirabilis, can lead to pulmonary embolism. Echocardiography is crucial for diagnosis in at-risk patients, with surgery offering satisfactory outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Device Technology
Background:
- The increasing prevalence of endocavitary pacemakers presents challenges in managing potential complications.
- Foreign bodies in cardiac cavities, such as pacemaker leads, are associated with thrombus formation and potential infection.
- Pulmonary embolism (PE) in patients with pacemakers necessitates investigation for intracardiac sources.
Observation:
- A patient with an endocardial pacemaker presented with recurrent pulmonary embolism and fever.
- Hemocultures revealed Proteus mirabilis infection.
- Bidimensional echocardiography identified an infected electrocatheter thrombus.
Findings:
- Proteus mirabilis was identified as the causative agent of the endocarditic thrombus.
- Surgical removal of the infected thrombus and pacemaker lead was performed.
- Post-operative recovery was satisfactory, with resolution of symptoms.
Implications:
- This case highlights the critical role of echocardiography in diagnosing intracardiac thrombosis in pacemaker patients with PE.
- Prompt diagnosis and surgical intervention are essential for managing infected pacemaker lead thrombosis.
- Understanding the link between specific pathogens like Proteus mirabilis and pacemaker-related complications is vital for clinical practice.