title: Not the usual cardiac rhythm device infection: a fastidious pathogen with several teaching points.
abstract: Because cardiac device infections may include fastidious pathogens, extended incubation of blood cultures is suggested. A patient with an infection of a right ventricular lead implantable cardioverter defibrillator (ICD) system is described. The device was implanted 6 months earlier. The pathogen was identified as Haemophilus parainfluenzae, which was cultured within 72 hours and was presumably from a respiratory tract infection. Extended incubation was not necessary to culture this fastidious pathogen. Two large retrospective studies suggest that prolonged incubation for fastidious organisms is generally not necessary because of advances in culture media and automated blood culture systems.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195-6422, USA. pcawley@u.washington.edu
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Cawley
authors.forename: Bipin K
authors.initials: BK
authors.lastname: Ravindrin
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Poole
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal; D017548:Echocardiography, Transesophageal; D005260:Female; D006192:Haemophilus Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone