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Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
Published on: September 24, 2021
A case report of pacemaker endocarditis presenting as osteitis in a high-surgical-risk patient: a management
Wassim Beladel1, Zakaria Chaib1, Caroline Birgy2
1Department of Cardiology, Agadir University Hospital Center, IBN ZOHR University, Agadir 80000, Morocco.
Background:
Cardiac implantable electronic device-related infective endocarditis is a serious and increasingly frequent complication, often presenting atypically in frail patients with multiple comorbidities.
Case Summary:
We report the case of an 83-year-old man admitted with fever and heel pain, who developed heart failure symptoms. Investigations revealed Staphylococcus aureus bacteraemia, osteitis, spondylodiscitis, and a large tricuspid valve vegetation (26 mm) attached to the pacemaker lead, complicated by pulmonary embolism. Given his high surgical risk and resistant Gram-positive bacteraemia, a multidisciplinary endocarditis team opted for percutaneous vegetation thromboaspiration and complete device extraction, and pacing was ensured via an externalized temporary-permanent pacing system. After infection clearance, a leadless pacemaker was successfully implanted. The clinical outcome was favourable, with no recurrence or complications on follow-up.
Conclusion:
This case emphasizes the importance of early suspicion, advanced imaging, and tailored management of cardiac implantable electronic device-related endocarditis. Leadless pacemakers and percutaneous aspiration represent valuable strategies in high-risk patients to reduce infection recurrence and embolic risk.
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