title: Fever and Cardiac Arrest in a Patient With a Left Ventricular Assist Device.
abstract: A 68-year-old avid deer hunter with ischemic cardiomyopathy underwent left ventricular assist device (LVAD) implantation for destination therapy two years ago. He was living an active lifestyle, tracking deer and fishing in a Midwestern forest in November. His wife removed an engorged tick on his thorax. A few days later, he experienced fever, confusion, and ataxia and was hospitalized with septic shock and ventricular fibrillation. The LVAD site had no signs of trauma, drainage, warmth, or tenderness. A peripheral blood smear revealed intraleukocytic anaplasma microcolony inclusions. After completing 14 days of doxycycline, he recovered. Typical non-device-associated infections in LVAD recipients include pneumonia, urinary tract infection, or Clostridium difficile colitis. Human granulocytic anaplasmosis (HGA) is a very atypical non-LVAD infection, and the incidence of tickborne illnesses in LVAD recipients is unknown.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine , Mayo Clinic , Rochester, Minnesota.
authors.forename: Eugene M
authors.initials: EM
authors.lastname: Tan
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine , Mayo Clinic , Rochester, Minnesota.
authors.forename: Jasmine R
authors.initials: JR
authors.lastname: Marcelin
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine , Mayo Clinic , Rochester, Minnesota.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Tande
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine , Mayo Clinic , Rochester, Minnesota.
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Rizza
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine , Mayo Clinic , Rochester, Minnesota.
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Cummins
keywords: Anaplasma; fever; left ventricular assist device