title: Aspergillus infection of implantable cardioverter-defibrillator.
abstract: The use of pacemakers and implantable cardioverter-defibrillators continues to increase for the management of cardiac dysrhythmias and, more recently, heart failure. Long-term complications associated with their use include infection, lead failure, and spurious shocks. Although the risk of infection with intracardiac devices is well known, the clinical presentation of this complication can be insidious, delayed in onset, and difficult to diagnose. We report a case of Aspergillus fumigatus infection of an implantable cardioverter-defibrillator with right-sided endocarditis in a 55-year-old man. The infection presented as persistent pulmonary infiltrates (due to recurrent septic pulmonary embolism) and anemia more than 2 years after implantation of the device. Clinicians should be aware of the variable manifestations resulting from infection of intracardiac devices.
authors.affiliation: Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Cook
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Orszulak
authors.forename: Vuyisile T
authors.initials: VT
authors.lastname: Nkomo
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Shuford
authors.forename: William D
authors.initials: WD
authors.lastname: Edwards
authors.forename: Jay H
authors.initials: JH
authors.lastname: Ryu
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000740:Anemia / Q000209:etiology*; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001232:Aspergillus fumigatus; D001706:Biopsy; D001799:Blood Sedimentation; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D014057:Tomography, X-Ray Computed
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B