Diagnosis and treatment of lead-dependent infective endocarditis.

We report a typical case of lead-dependent infective endocarditis in an 84 year-old patient, occurring two years after pacemaker implantation. Before the correct diagnosis was reached, the patient was repeatedly hospitalised in several centres due to fever of unknown origin. Eventually, the diagnosis was confirmed when the patient was referred for transoesophageal echocardiography by a consulting cardiologist from the pacemaker implantation centre. The successful treatment included the removal of the whole pacing system with endocardial leads and adequate antibiotic therapy.