Mycobacterium phlei, a previously unreported cause of pacemaker infection: thinking outside the box in cardiac device...

Area of Science:

• Infectious Diseases
• Medical Device Infections
• Mycobacterial Infections

Background:

• Cardiac device-related infections (CDI) are an increasing concern with the widespread use of cardiac rhythm management devices.
• Staphylococcus aureus and Staphylococcus epidermidis are the most common pathogens responsible for the majority of CDI.
• Infections caused by rapidly growing non-tuberculous mycobacteria are exceptionally rare, with fewer than ten cases documented previously.

Observation:

• This case report describes a pacemaker pocket infection.
• The causative agent identified was Mycobacterium phlei.
• Mycobacterium phlei is generally considered a non-pathogenic organism, with only three prior reports of human infection.

Findings:

• This represents the first documented case of cardiac device-related infection specifically caused by Mycobacterium phlei.
• The study highlights a rare instance of a typically non-pathogenic mycobacterium causing a significant clinical infection.

Implications:

• This case expands the known spectrum of pathogens associated with cardiac device infections.
• It underscores the importance of considering unusual organisms in the diagnosis of refractory or atypical device infections.
• Further research may be warranted to understand the pathogenicity of Mycobacterium phlei in immunocompromised or device-implanted patients.