Infection of an implantable cardioverter defibrillator: management without removal of the device in selected cases.
A case is presented in which an implantable cardioverter defibrillator (ICD) became infected in the abdominal wall pocket 5 weeks following implantation. There was no evidence clinically or by computed tomographic scan suggesting mediastinal extension of the infection. The infection was treated successfully by debriding the abdominal wall pocket followed by a combination of pocket irrigation with antibiotic solution, parenteral antibiotics, and long-term oral antibiotics. This conservative therapy was successful and avoided removal of the device.
Division of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio.
R L
RL
Taylor
D J
DJ
Cohen
L E
LE
Widman
R J
RJ
Chilton
R A
RA
O'Rourke
D000009:Abdominal Muscles; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003646:Debridement; D004554:Electric Countershock / Q000009:adverse effects* / Q000295:instrumentation; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D012706:Serratia marcescens; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology; D013530:Surgical Wound Infection / Q000628:therapy*; D007507:Therapeutic Irrigation
D000900:Anti-Bacterial Agents