Automatic Implantable Cardioverter Defibrillator Lead-related Endocarditis due to Staphylococcus lugdunensis

Area of Science:

• Microbiology
• Infectious Diseases
• Cardiology

Background:

• Staphylococcus lugdunensis (CoNS) is increasingly recognized as a pathogen, not just skin flora.
• Biofilm formation is key to S. lugdunensis pathogenesis, particularly on foreign bodies.
• S. lugdunensis endocarditis exhibits high mortality, comparable to Staphylococcus aureus.

Observation:

• A patient presented with psoas abscess and S. lugdunensis bacteremia.
• Infective endocarditis was identified on the defibrillator wire of an automatic implantable cardioverter defibrillator (AICD).

Findings:

• S. lugdunensis caused infective endocarditis in a patient with an AICD.
• The infection involved a vegetation on the AICD's right ventricular wire.
• Successful treatment required device explantation and extended antibiotic therapy.

Implications:

• S. lugdunensis poses a significant threat in patients with implanted electronic devices.
• Early recognition and aggressive management, including device removal, are crucial for S. lugdunensis endocarditis.
• This case underscores the need for vigilance regarding CoNS pathogens in clinical practice.