Cook Rachel J, Orszulak Thomas A, Nkomo Vuyisile T, Shuford Jennifer A, Edwards William D, Ryu Jay H
Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
Mayo Clin Proc. 2004 Apr;79(4):549-52. doi: 10.4065/79.4.549.
The use of pacemakers and implantable cardioverter-defibrillators continues to increase for the management of cardiac dysrhythmias and, more recently, heart failure. Long-term complications associated with their use include infection, lead failure, and spurious shocks. Although the risk of infection with intracardiac devices is well known, the clinical presentation of this complication can be insidious, delayed in onset, and difficult to diagnose. We report a case of Aspergillus fumigatus infection of an implantable cardioverter-defibrillator with right-sided endocarditis in a 55-year-old man. The infection presented as persistent pulmonary infiltrates (due to recurrent septic pulmonary embolism) and anemia more than 2 years after implantation of the device. Clinicians should be aware of the variable manifestations resulting from infection of intracardiac devices.
起搏器和植入式心脏复律除颤器在心律失常管理中的应用持续增加，最近在心力衰竭管理中也越来越常用。与使用这些设备相关的长期并发症包括感染、导线故障和假性电击。尽管心内装置感染的风险众所周知，但这种并发症的临床表现可能隐匿、起病延迟且难以诊断。我们报告一例55岁男性患者，其植入式心脏复律除颤器发生烟曲霉感染并伴有右侧心内膜炎。感染表现为植入该装置2年多后出现持续的肺部浸润（由于反复发生的脓毒性肺栓塞）和贫血。临床医生应意识到心内装置感染可能产生的多种表现。
