title: Pacemaker lead endocarditis caused by Achromobacter xylosoxidans.
abstract: We report the case of a 35-yr-old patient who presented with high fever and chills. He had undergone a patch closure of the ventricular septal defect 18 yr before. One year later, a VVI pacemaker was implanted via the right subclavian vein because of complete heart block. Nine years after that, a new VVI pacemaker with another right ventricular electrode was inserted controlaterally and the old pacing lead was abandoned. Trans-thoracic and trans-esophageal echocardiogram identified the pacemaker lead in the right ventricle (RV) attaching hyperechoic materials and also a fluttering round hyperechoic mass with a stalk in the RV outflow tract. Cultures in blood and pus from pacemaker lead grew Achromobacter xylosoxidans. A diagnosis of pacemaker lead endocarditis due to Achromobacter xylosoxidans was made. In this regards, the best treatment is an immediate removal of the entire pacing system and antimicrobial therapy.
authors.affiliation: Division of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Nam Ho
authors.initials: NH
authors.lastname: Kim
authors.forename: Dong Hyeon
authors.initials: DH
authors.lastname: Shin
authors.forename: Ok Young
authors.initials: OY
authors.lastname: Park
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: D042441:Achromobacter denitrificans; D000328:Adult; D004567:Electrodes, Implanted / Q000382:microbiology; D004696:Endocarditis / Q000000981:diagnostic imaging* / Q000382:microbiology; D016905:Gram-Negative Bacterial Infections / Q000000981:diagnostic imaging*; D006327:Heart Block / Q000628:therapy; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000382:microbiology*; D014463:Ultrasonography