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Intractable late onset pacemaker endocarditis and complications case report.
Gaelle Ghazal1, Michel Boueiz1, Georgio El Koubayati1
1Internal Medicine, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon.
Heliyon
|November 18, 2024
Summary
Late-onset pacemaker endocarditis caused by Serratia marcescens infection required open-heart surgery. This case highlights the need for prompt diagnosis and surgical intervention for cardiac implantable electronic device infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Intervention
Background:
- Cardiac implantable electronic devices (CIEDs) have transformed cardiac care but are susceptible to infections, with reported rates from 1% to 15%.
- CIED infections, particularly endocarditis, can lead to severe complications and necessitate aggressive treatment strategies.
Observation:
- A 50-year-old female with a 20-year-old pacemaker presented with fever and purulent discharge.
- Diagnostic tests confirmed Serratia marcescens infection, which persisted despite antibiotic therapy.
- Echocardiography revealed tricuspid valve vegetations, indicating endocarditis.
Findings:
- The patient underwent open-heart surgery for complete lead removal, tricuspid valvuloplasty, and epicardial pacemaker implantation.
- Surgical intervention was curative, resolving the late-onset pacemaker endocarditis.
- This case underscores the challenges associated with Serratia marcescens CIED infections.
Implications:
- Emphasizes the critical role of interdisciplinary management in optimizing outcomes for CIED infections.
- Highlights the necessity of early diagnosis and prompt, comprehensive surgical approaches for successful treatment.
- Reinforces that even with antibiotic therapy, surgical intervention may be the only curative option for complex CIED infections.
Keywords:
CIED infectionsCardiac implantable electronic devicesCase reportEndocarditisEpicardial pacemakerInterdisciplinary managementPacemakersSerratia marcescensSurgical interventionTricuspid valveMore Related Videos
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