Related Experiment Video

Updated: Feb 25, 2026

Translational Rabbit Model of Chronic Cardiac Pacing
06:14

Translational Rabbit Model of Chronic Cardiac Pacing

Published on: January 6, 2023

3.2K

Recurrent FUO due to intermittent Enterobacter cloacae bacteremias from an infected pacemaker lead diagnosed by

Burke A Cunha1,2, Ismail Jimada1,2

  • 1a Infectious Disease Division , Winthrop-University Hospital , Mineola , NY , USA.

Infectious Diseases (London, England)
|August 4, 2017
PubMed

Insights

Recurrent fever of unknown origin (FUO) in a 70-year-old male was finally diagnosed using gallium scanning. This revealed a pacemaker lead infection, which was successfully treated by explantation.

Area of Science:

  • Infectious Diseases
  • Diagnostic Imaging

Background:

  • Fever of unknown origin (FUO) is defined as fever ≥101°F lasting ≥3 weeks without a diagnosis after extensive workup.
  • Recurrent FUOs, especially with intermittent fevers, pose diagnostic challenges.
  • Device-related infections are a potential cause of recurrent FUO.

Observation:

  • A 70-year-old male presented with recurrent FUO and intermittent Enterobacter cloacae bacteremia.
  • Initial workups, including indium and PET scans, failed to identify the infection source.
  • The patient had a penile implant and a permanent pacemaker (PPM).

Findings:

  • Gallium scanning identified enhanced uptake on a cardiac lead, indicating a device-related infection.
  • The pacemaker lead was explanted and grew Enterobacter cloacae.
  • The patient became fever-free after lead removal and antibiotic treatment.

Implications:

  • Gallium scanning is a valuable tool for FUO diagnosis, especially when other imaging modalities yield false-negative results.
  • Prompt identification and removal of infected devices are crucial for managing recurrent FUO.
  • This case highlights the importance of considering device infections in patients with recurrent FUO and bacteremia.
Keywords:
Recurrent FUOsfalse-positive indium and PET scansinfectious causes of FUOnosocomial Enterobacter cloacae bacteremiasnosocomial FUOsnosocomial cardiac device-associated infections

More Related Videos

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation08:56

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

Published on: September 24, 2021

3.2K
Recurrent Escherichia coli Urinary Tract Infection Triggered by Gardnerella vaginalis Bladder Exposure in Mice08:53

Recurrent Escherichia coli Urinary Tract Infection Triggered by Gardnerella vaginalis Bladder Exposure in Mice

Published on: December 4, 2020

6.9K

Related Concept Videos

Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
610
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
291
Pericarditis II: Clinical Features and Diagnostic Tests01:19

Pericarditis II: Clinical Features and Diagnostic Tests

Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
424
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
438
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
383
Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
590