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Extremely late pacemaker-infective endocarditis due to Stenotrophomonas maltophilia

Masateru Takigawa1, Takashi Noda, Takashi Kurita

  • 1Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan. tama@hsp.ncvc.go.jp

Cardiology
|December 13, 2007
PubMed

Insights

A rare pacemaker infection by Stenotrophomonas maltophilia occurred 17 years post-implantation. Treatment involved antibiotics, surgical removal of the infected pacemaker system, and re-implantation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Infections

Background:

  • Pacemaker systems are crucial for cardiac rhythm management.
  • Intravascular infections associated with cardiac implantable electronic devices (CIEDs) pose significant challenges.
  • Stenotrophomonas maltophilia is an opportunistic pathogen, rarely implicated in CIED infections.

Observation:

  • A case report detailing a patient with a pacemaker system infection.
  • The infection was caused by Stenotrophomonas maltophilia.
  • The infection manifested 17 years after the initial pacemaker implantation.

Findings:

  • The patient received appropriate antibiotic therapy tailored to Stenotrophomonas maltophilia.
  • Surgical intervention included debridement of infected tissue and complete removal of the pacemaker system via open heart surgery.
  • Successful treatment led to discharge after a 6-week antibiotic course and new pacemaker implantation.

Implications:

  • Highlights the possibility of late-onset CIED infections, even years after implantation.
  • Underscores the importance of considering Stenotrophomonas maltophilia in CIED infections.
  • Demonstrates the necessity of a multidisciplinary approach involving cardiology, infectious diseases, and cardiothoracic surgery for managing complex CIED infections.

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