Invasive Listeriosis of Intracardiac Device

Area of Science:

• Infectious Diseases
• Cardiology
• Medical Microbiology

Background:

• Listeria monocytogenes is a foodborne pathogen causing invasive infections, particularly in immunocompromised individuals, pregnant women, and the elderly.
• Listeria endocarditis is a rare condition, with limited literature on its impact on intracardiac devices.
• This report details a case of Listeria infection associated with a cardiac device.

Observation:

• A 74-year-old male with multiple cardiac conditions presented with fatigue and was diagnosed with Listeria bacteremia.
• Transthoracic echocardiogram revealed vegetation on the pacemaker lead, indicating an intracardiac device infection.
• The patient received a 6-week course of vancomycin followed by amoxicillin suppression.

Findings:

• Listeria can infect native valves, prosthetic valves, and nonvalvular intracardiac devices, including pacemakers.
• While Listeria prosthetic valve endocarditis has been reported, pacemaker lead infections are less documented.
• Treatment typically involves antibiotics (penicillin and aminoglycosides) for 4-6 weeks, often with preferred surgical device removal.

Implications:

• This case highlights the importance of considering Listeria in patients with intracardiac device infections.
• Prompt diagnosis and treatment of invasive listeriosis are essential for preventing fatal outcomes.
• Further research into Listeria infections of cardiac devices is warranted to improve clinical management.