title: A challenging lead endocarditis.
abstract: Pacemaker/implantable cardioverter-defibrillator (ICD) lead endocarditis remains a challenging diagnosis in cardiology. Several parameters can be involved in the clinical path leading to the definite diagnosis. Clinical appearance and physical findings, together with transoesophageal echocardiography and serum levels of inflammatory parameters, are necessary in the workup towards the diagnosis. It is highly unlikely that ICD-lead vegetation is accompanied by positive blood cultures solely. We describe a case of ICD-infected endocarditis with positive blood cultures for Staphylococcus epidermidis without any physical findings or raised inflammatory parameters in serum plasma levels. In this case, three-dimensional echocardiography demonstrated an added value to two-dimensional echocardiography.
authors.affiliation: Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Mihl
authors.forename: Z
authors.initials: Z
authors.lastname: Geyik
authors.forename: E C
authors.initials: EC
authors.lastname: Cheriex
authors.forename: J M
authors.initials: JM
authors.lastname: van Opstal
mesh_terms: D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004566:Electrodes / Q000009:adverse effects; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D014463:Ultrasonography