Diagnosis of pacemaker lead infection using transoesophageal echocardiography: a case report.
BACKGROUND
Vegetative lead infection is an uncommon complication of permanent pacemaker implantation. The diagnosis is difficult using conventional imaging methods.


METHODS
An elderly Indian woman with a history of diabetes mellitus developed Staphylococcus aureus infection after implementation of a permanent pacemaker. Following a non-diagnostic transthoracic echocardiogram, transoesophageal echocardiography was performed and showed a large vegetative mass attached to the pacemaker lead within the right atrium.


METHODS
The pacemaker was removed and intravenous vancomycin administered for six weeks.


RESULTS
She was discharged well but demised two months later from a second episode of septicaemia.


CONCLUSIONS
Pacemaker lead infection remains a challenging management problem. Transoesophageal echocardiography can facilitate its diagnosis.
Tan
H H
HH
Department of Medicine, National University Hospital, Singapore.
Ling
L H
LH
Ng
W L
WL
Cheng
A
A
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000188:drug therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin