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A Case of Pacemaker Endocarditis Caused by Aerococcus urinae
Sandra Samuelsson1, Charles Kennergren2, Magnus Rasmussen3,4
1Department of Infectious Diseases, Hospital of Halland, Halmstad, Sweden.
Case Reports in Infectious Diseases
|April 26, 2018
Summary
Aerococcus urinae can infect cardiac implanted electronic devices (CIEDs), a previously unreported complication. This risk should be considered in patients with A. urinae bacteremia and a CIED, particularly if infections recur.
Area of Science:
- Infectious Diseases
- Cardiology
- Medical Microbiology
Background:
- Aerococcus urinae is increasingly recognized as a cause of infective endocarditis (IE), particularly in elderly males with urinary tract issues.
- Cardiac implanted electronic devices (CIEDs) are common in this demographic.
- Despite A. urinae's in vitro biofilm formation, CIED infections by this pathogen were previously unreported.
Observation:
- An 84-year-old male with a pacemaker presented with symptoms of urinary tract infection and A. urinae bacteremia.
- Initial transesophageal echocardiography (TEE) showed no vegetations; however, a subsequent admission revealed a vegetation on the tricuspid valve or pacing leads.
- The infected pacemaker system was removed and replaced after a course of antibiotics.
Findings:
- This case report confirms Aerococcus urinae as a causative agent of CIED infection.
- The patient experienced recurrent bacteremia, highlighting a potential risk factor.
Implications:
- Clinicians should consider A. urinae CIED infection in patients with A. urinae bacteremia and a CIED.
- Vigilance is crucial, especially in cases of recurrent bacteremia, to ensure timely diagnosis and treatment of this serious complication.
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