Candida albicans endocarditis with giant vegetation from an implantable cardioverter-defibrillator lead

Endocarditis is a potentially lethal complication of implantation of a cardioverter-defibrillator (ICD).

We report the case of a 62-year-old male with candidemia and vegetation from a large implantable ICD lead that could not be extracted percutaneously. The ICD system was completely and successfully removed through pocket re-exploration and sternotomy with cardiopulmonary bypass.

Although the patient was considered at high risk from thrombocytopenia, systemic infection, and symptomatic heart failure with a very low ejection fraction, the surgical procedure used to remove his ICD provided a good clinical outcome.

An early and aggressive combination of surgical and medical therapy is effective for the removal of an ICD causing endocarditis, and reimplantation of the device is safe when guided by principles for preventing infection.