[Pacemaker lead endocarditis: analysis of 11 cases].
BACKGROUND
The prevalence of infection of permanent pacemaker ranges from 0.13 to 19.9%. Our objective is to review our experience and to analyze the epidemiology and treatment of those diagnosed as having pacemaker lead endocarditis.


METHODS
A retrospective study include all cases diagnosis of pacemaker endocarditis in our hospital, since 1991 to 1998. Eleven patients with pacemaker endocarditis were included.


RESULTS
Eleven patients were admitted for endocarditis related to pacemaker-lead infection. Fever occurred in nine patients (81.8%). A germ was isolated in nine patients (81.8%) and was a Staphylococcus in eight (88.9%). Transthoracic echocardiography demonstrated vegetations in only two patients (18.2%), whereas transesophageal echocardiography disclosed abnormal appearances on the pacemaker lead in eleven patients (100%). Six patients were treated with antibiotics initially and four patients required the removal of the whole infected material after finishing treatment with antibiotic. Five patients were treated since the beginning with a electrode removal who responded favorably.


CONCLUSIONS
The diagnosis of endocarditis related to pacemaker infection should be suspected in the presence of fever and patient with pacemaker. Transesophageal echocardiography should be performed to look for vegetations. S. aureus and S. epidermidis are involved in the majority of these infections. The best treatment is an immediate removal of the entire pacing system and antimicrobial therapy.
Baños
R
R
Servicio de Medicina Interna, Hospital Universitario Virgen de la Arrixaca, Murcia.
Gómez
J
J
Sánchez
B
B
de la Morena
G
G
Simarro
E
E
García del Real
F
F
D000368:Aged; D000369:Aged, 80 and over; D002444:Cefuroxime / Q000627:therapeutic use; D003023:Cloxacillin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D020878:Device Removal; D003920:Diabetes Mellitus / Q000453:epidemiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D004866:Equipment Contamination; D004927:Escherichia coli Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D015995:Prevalence; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D014640:Vancomycin / Q000627:therapeutic use
D005839:Gentamicins; D014640:Vancomycin; D002444:Cefuroxime; D003023:Cloxacillin; D012293:Rifampin