De Silva Kalpa, Fife Amanda, Murgatroyd Francis, Gall Nicholas
St Thomas' Hospital, Department of Cardiology, Westminster Bridge Road, London SE1 7EH, UK.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.02.2009.1608. Epub 2009 Nov 18.
Pacemaker endocarditis remains a rare but potentially life threatening complication of pacemaker implantation. This case illustrates a rare cause of pacemaker endocarditis, Serratia marcescens, the management difficulties that can be faced with such organisms, and the potential indolent nature of pacemaker lead associated endocarditis. A review of the current data for pacemaker endocarditis management suggests that treatment with antimicrobials alone is unlikely to be curative and explantation of the device is recommended in all cases of confirmed pacemaker endocarditis (by echocardiography, in correlation with the patient's clinical condition and inflammatory markers).
起搏器心内膜炎仍然是起搏器植入术后一种罕见但可能危及生命的并发症。本病例说明了起搏器心内膜炎的一种罕见病因——粘质沙雷氏菌，面对这类微生物时可能遇到的管理难题，以及起搏器导线相关心内膜炎潜在的隐匿性。对目前起搏器心内膜炎管理数据的回顾表明，单独使用抗菌药物治疗不太可能治愈，对于所有确诊的起搏器心内膜炎病例（通过超声心动图，并结合患者的临床状况和炎症标志物），建议取出装置。
