Pacemaker lead endocarditis caused by Achromobacter xylosoxidans.
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.
Ahn
Youngkeun
Y
Division of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
Kim
Nam Ho
NH
Shin
Dong Hyeon
DH
Park
Ok Young
OY
Kim
Won
W
Jeong
Myung Ho
MH
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Kang
Jung Chaee
JC
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