Glomerulonephritis associated with permanent pacemaker endocarditis

Two patients with permanent transvenous cardiac pacemakers were seen with a history of pyrexia of unknown origin and renal failure. After extensive investigation both were found to have pacemaker endocarditis. A renal biopsy of one patient revealed changes characteristic of glomerulonephritis associated with this condition. Both patients underwent thoracotomy for open removal of their pacemaker and appropriate antibiotic treatment. One patient made a good recovery of renal function. Unfortunately the second patient died. These reports emphasize the need for vigilance for these two uncommon complications and the difficulty in their diagnosis.