Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA.
BMJ Case Rep. 2022 Jul 12;15(7):e249795. doi: 10.1136/bcr-2022-249795.
We report the first known case of -associated pacemaker lead endocarditis-a disease whose incidence and mortality are growing. A woman in her 70s with a history of transcatheter aortic valve replacement and pacemaker placement 7 months earlier presented with recurrent fevers. She visited the emergency department several times during the past 2 months for these fevers, and she had been given oral antibiotics for presumed urinary tract infections. Investigations revealed blood cultures growing Although transthoracic echocardiogram was negative, transesophageal echocardiogram showed two vegetations on the right atrial lead which suggested pacemaker lead-associated endocarditis. A complete pacemaker and lead extraction was performed, and the patient recovered completely and was discharged home to complete 6 weeks of intravenous ceftriaxone with plans for follow-up echocardiography. We hope that this case will contribute to the growing body of literature regarding device infections, thus leading to earlier identification and treatment.
我们报告了首例与起搏器导线相关的心内膜炎病例——这种疾病的发病率和死亡率正在上升。一位 70 多岁的女性,有经导管主动脉瓣置换术和 7 个月前放置起搏器的病史,出现反复发热。在过去的 2 个月里,她因这些发热多次前往急诊部就诊,曾被给予口服抗生素治疗疑似尿路感染。检查显示血液培养物中生长出 尽管经胸超声心动图检查为阴性,但经食管超声心动图显示右心房导线上有两个赘生物,提示与起搏器导线相关的心内膜炎。进行了完全的起搏器和导线拔除,患者完全康复并出院回家,完成 6 周的静脉头孢曲松治疗,并计划进行后续超声心动图检查。我们希望这个病例能够为不断增加的关于器械感染的文献做出贡献,从而更早地识别和治疗。