Delpierre S, Le Heiget H, Sauvaget F, Sevin E, Montagne O, Lejonc J L
Service d'Urgences-Médecine Générale, Hôpital Henri-Mondor, Créteil.
Ann Med Interne (Paris). 1999 Apr;150(3):265-8.
Systemic infection related to transvenous pacemaker-leads are rare, but their diagnosis is difficult. We report the observation of a 78-year-old patient whose recurrent Staphylococcus aureus septicemias linked to endocarditis related to an endovascular lead only on a third observation, characterized by an infectious bone localization. Transoesophageal echocardiography appears as the reference diagnostic method. The treatment lies in the surgical ablation of the pacing system and a prolonged antibiotic therapy. The heavy mortality caused by these pathologies leads us to reconsider the interest of a prophylaxis, particularly for elderly patients.
与经静脉起搏器导线相关的全身感染很少见,但其诊断困难。我们报告了一名78岁患者的观察情况,该患者反复出现金黄色葡萄球菌败血症,与仅在第三次观察时发现的与血管内导线相关的心内膜炎有关,其特征为感染性骨定位。经食管超声心动图似乎是参考诊断方法。治疗在于手术切除起搏系统并进行长期抗生素治疗。这些病症导致的高死亡率促使我们重新考虑预防的意义,特别是对于老年患者。