Löffler S, Kasper J, Postulka J, Cornák V, Bohunický F, Zelenay J, Tréger J
Institute of Cardiovascular Diseases, Bratislava, Czechoslovakia.
Cor Vasa. 1988;30(6):400-4.
Nine patients with implanted pacemakers had the diagnosis of septicaemia to endocarditis. The diagnosis was established on the basis of a repeatedly positive haemoculture. The interval since the first pacemaker implantation to the onset of sepsis to endocarditis was about 5 years. All nine patients had previous reoperation either of the pacemaker or its lead due to decubitus. While, in four patients, the route of infection was a pacemaker lead in its extravascular couse, in 5 patients the source of infection was a lead placed right in the venous system. All patients were treated with ATB according to the antibioticogram. 4 patients had the pacemaker lead extracted. In the remaining five, the pacemaker lead was removed by catheterization. All patients recovered. There is only one way of eliminating infection that caused the sepsis, that is, to remove the foreign body present in the patient - the pacemaker leas in this particular case.
9例植入起搏器的患者被诊断为败血症性心内膜炎。诊断基于血培养多次阳性得以确立。从首次植入起搏器到败血症性心内膜炎发作的间隔时间约为5年。所有9例患者此前均因褥疮对起搏器或其导线进行了再次手术。其中,4例患者的感染途径是起搏器导线在血管外走行过程中,5例患者的感染源是直接置于静脉系统的导线。所有患者均根据药敏试验接受了抗菌药物治疗。4例患者拔除了起搏器导线。其余5例患者通过导管插入术移除了起搏器导线。所有患者均康复。消除导致败血症的感染的唯一方法是,去除患者体内存在的异物——在这种特殊情况下即起搏器导线。