Infective endocarditis due to a cardiac pacemaker infection: a case report
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Introduction: Infective endocarditis (IE) related to cardiac implantable electronic devices (CIED) is a potentially fatal complication that may compromise the generator, leads, or cardiac valves. Most cases occur in multimorbid patients and are frequently caused by Staphylococcus aureus or S. epidermidis.
Case report: An elderly patient with a dual-chamber pacemaker implanted four years earlier was admitted with sepsis, fever, and acute kidney injury. On examination, exposure of the generator unit with purulent discharge was noted. Echocardiography showed vegetations on the ventricular lead and the right atrial wall, and blood cultures were positive for S. aureus. Computed tomography revealed multiple cavitary nodules compatible with septic emboli. Device extraction was performed, followed by pathogen-directed antibiotic therapy for four weeks, with favorable progression and hospital discharge without sequelae.
Conclusion: CIED-related IE requires rapid diagnosis and aggressive management. Microbiological confirmation, early detection of complications, and device removal combined with appropriate antibiotics were decisive for the favorable outcome.
Keywords: infective endocarditis; artificial pacemaker; cardiac implantable electronic device
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