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Aspergillus fumigatus infection of an automatic internal cardiac defibrillator
C J Dunn1, M Ruder, S C Deresinski
1Department of Medicine, Sequoia Hospital, Redwood City, California, USA.
Abstract:
We report a patient without immune compromise with infection of an automatic internal cardiac defibrillator patch due to Aspergillus fumigatus presenting 8 years after implantation. The mechanism of infection was unknown, but symptoms began 1 month after laser uvulopalatopharyngoplasty was performed for sleep apnea. The patches were surgically removed and the patient was treated sequentially with amphotericin B and itraconazole. He remains without evidence of infection 12 months after the completion of therapy.
Insights
A rare Aspergillus fumigatus infection of an automatic internal cardiac defibrillator patch occurred 8 years post-implantation. Prompt surgical removal and antifungal treatment led to successful patient recovery.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Mycology
Background:
- Automatic internal cardiac defibrillator (AICD) implantation is a common procedure for managing life-threatening arrhythmias.
- Device-related infections can occur, but late-onset infections are less common, especially in immunocompetent patients.
- Aspergillus fumigatus is an opportunistic mold that can cause invasive infections.
Observation:
- A patient without immune compromise developed an AICD patch infection due to Aspergillus fumigatus, 8 years after implantation.
- Symptoms emerged one month after undergoing laser uvulopalatopharyngoplasty for sleep apnea, though the infection mechanism remains unclear.
- The patient presented with a late-onset, device-associated fungal infection.
Findings:
- Surgical explantation of the infected AICD patches was performed.
- The patient received sequential treatment with amphotericin B and itraconazole.
- Complete resolution of the Aspergillus fumigatus infection was achieved.
Implications:
- This case highlights the possibility of late-onset Aspergillus infections associated with cardiac implantable electronic devices.
- It underscores the importance of considering fungal etiologies in device infections, even years after implantation and in the absence of traditional risk factors.
- Early diagnosis, surgical intervention, and appropriate antifungal therapy are crucial for managing such rare but serious complications.