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Clostridioides (Clostridium) difficile Pacemaker Infection
Anna Berkefeld1, Fabian K Berger2, Barbara C Gärtner2
1Department of Internal Medicine I, Technical University of Munich, School of Medicine, Munich, Germany.
Open Forum Infectious Diseases
|December 16, 2020
Summary
Clostridioides difficile infections can extend beyond the gut, causing rare bloodstream and device infections. This case highlights the risk even from asymptomatic C. difficile colonization to prosthetic material.
Area of Science:
- Infectious Diseases
- Microbiology
- Medical Devices
Background:
- Clostridioides difficile is a primary cause of antibiotic-associated diarrhea.
- Extraintestinal manifestations of C. difficile are uncommon.
- Intravascular devices are susceptible to microbial colonization.
Observation:
- A patient presented with bloodstream infection and pacemaker pocket/lead infection.
- The causative agent was identified as toxigenic C. difficile ribotype 014.
- The patient lacked typical gastrointestinal symptoms.
Findings:
- Genotyping confirmed clonality between C. difficile pacemaker and intestinal isolates.
- Pacemaker extraction and vancomycin treatment were performed.
- This represents the first documented case of C. difficile bacteraemia with pacemaker infection.
Implications:
- C. difficile poses a risk for intravascular device infections.
- Asymptomatic C. difficile colonization may lead to prosthetic material infections.
- Highlights the importance of considering C. difficile in device-related infections, even without diarrhea.
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