How sweet is the pacemaker?

I Merinopoulos1, S O'Toole, J N Porter

  • 1I Merinopoulos, Department of Cardiology, Papworth Hospital, Cambridge CB23 3RE, UK. Email ioannis.merinopoulos@doctors.org.uk.

Insights

Diagnosing pacemaker infections is challenging due to vague symptoms. This case highlights chronic pacemaker wire infection presenting as Sweet's syndrome, a rare sign of infective endocarditis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Dermatology

Background:

  • Pacemaker infections pose diagnostic challenges, often presenting with non-specific symptoms long after device implantation.
  • Chronic, low-grade sepsis from undetected pacemaker infections can lead to severe multisystem disease, increasing mortality and morbidity.

Observation:

  • This report details a case of chronic pacemaker wire infection.
  • The infection eventually manifested as Sweet's syndrome, an uncommon presentation.

Findings:

  • Sweet's syndrome is a rare but significant manifestation of infective endocarditis.
  • Identifying the pacemaker as the source of sepsis is crucial for effective treatment.

Implications:

  • A high index of suspicion is necessary for diagnosing pacemaker-related sepsis.
  • Early identification and treatment of pacemaker infections can prevent severe systemic complications and improve patient outcomes.

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