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Staphylococcus simulans bloodstream infection following CIED extraction
John Raymond Go1, Cristina Corsini Campioli1, Daniel DeSimone1
1Division of Infectious Disease, Mayo Clinic Minnesota, Rochester, Minnesota, USA.
BMJ Case Reports
|May 28, 2021
Summary
An elderly patient with an implantable cardioverter-defibrillator (ICD) developed a severe infection with Staphylococcus bacteria after a device extraction. Despite treatment, the patient experienced septic shock and ultimately expired.
Area of Science:
- Infectious Diseases
- Cardiology
- Medical Device Infections
Background:
- A 78-year-old male with a history of heart failure and complete heart block had an implantable cardioverter-defibrillator (ICD).
- The patient presented with symptoms of infection, including chills and malaise, and an open wound over the ICD site.
Observation:
- Initial blood cultures were negative, and transesophageal echocardiogram showed no vegetations.
- The patient underwent a prolonged ICD extraction procedure.
Findings:
- Postoperatively, the patient developed septic shock.
- Device and blood cultures identified Staphylococcus simulans and Staphylococcus epidermidis.
- Treatment with vancomycin was ineffective, leading to refractory hypotension and multiorgan failure.
Implications:
- This case highlights the risk of device-related infections, even with coagulase-negative Staphylococci.
- Potential environmental acquisition of Staphylococcus simulans from farm animals is suggested.
- Prolonged device extraction procedures may increase the risk of bacteremia.
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