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Native valve endocarditis and pacemaker infection with Mycobacterium fortuitum
Moamen Al Zoubi1,2, Joyce Cheng2, Venkate S Dontaraju2
1Department of Infectious Disease, Mercyhealth, Rockford, IL, USA.
Idcases
|June 30, 2021
Summary
A rare case of pacemaker infection and endocarditis caused by Mycobacterium fortuitum is presented. Prompt surgical removal and a six-week multidrug regimen led to successful patient recovery.
Area of Science:
- Infectious Diseases
- Cardiology
- Medical Microbiology
Background:
- Cardiac device infections and endocarditis are serious complications in healthcare settings.
- Mycobacterium fortuitum, a rapidly growing mycobacterium, can cause opportunistic infections.
Observation:
- A patient presented with symptoms of pacemaker infection, including fever, chills, and local swelling.
- Tricho-spid valve vegetation was noted, indicating native valve endocarditis.
Findings:
- The infection was confirmed to be caused by Mycobacterium fortuitum.
- Surgical removal of the infected pacemaker system was performed.
- A comprehensive multidrug regimen including azithromycin, levofloxacin, imipenem/cilastatin, and amikacin, followed by trimethoprim/sulfamethoxazole and doxycycline, was administered.
Implications:
- This case highlights the importance of considering atypical pathogens like Mycobacterium fortuitum in cardiac device infections.
- Early diagnosis and aggressive treatment, including surgical intervention and prolonged antimicrobial therapy, are crucial for favorable outcomes.
- Further research into the management of Mycobacterium fortuitum cardiac infections is warranted.
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