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Cardiac device-associated lead infection: a diagnosis not to be missed.

Marquette M, Budhdeo S, Rajagopal V, Marinescu M - Oxf Med Case Reports (2015)

Bottom Line: His symptoms worsened 2 weeks prior to presentation.He experienced swinging pyrexia, night sweats and shortness of breath on exertion.The patient made a full recovery and a new device was implanted.

View Article: PubMed Central - HTML - PubMed

Affiliation: Peterborough City Hospital , Peterborough PE3 9GZ , UK.

ABSTRACT
A 66-year-old gentleman was admitted to hospital with a history of general malaise for 5 months. His symptoms worsened 2 weeks prior to presentation. He experienced swinging pyrexia, night sweats and shortness of breath on exertion. Initial evaluation did not reveal any source of infection. Subsequent investigation revealed infection with vegetation affecting the intra-cardiac leads of cardiac resynchronization therapy device (CRT-D). The patient was treated with prolonged intravenous antibiotics and removal of the device and indwelling leads. The patient made a full recovery and a new device was implanted.

No MeSH data available.


Related in: MedlinePlus

(a–d) Transoesophageal echocardiogram images which show a hypoechogenic linear structure which represents the vegetation and not a loop of the pacemaker lead, which would be hyperechogenic. The vegetation is attached to the atrial segment of the pacemaker lead and is distant from other heart structures. The vegetation is indicated with an arrow in (c) and is labelled in (d).
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OMV014F1: (a–d) Transoesophageal echocardiogram images which show a hypoechogenic linear structure which represents the vegetation and not a loop of the pacemaker lead, which would be hyperechogenic. The vegetation is attached to the atrial segment of the pacemaker lead and is distant from other heart structures. The vegetation is indicated with an arrow in (c) and is labelled in (d).

Mentions: Multiple blood cultures were consistently positive for Staphylococcus aureus. These consisted of three separate sets of blood culture bottles, taken and sent for analysis within the first 24 h of admission. No antibiotic therapy was started at this stage. Two sets of blood culture bottles were positive. CT pulmonary angiogram showed segmental emboli with a small area of pulmonary infarction. Trans-thoracic echocardiography did not identify any new pathology. Subsequently, trans-oesophageal echocardiography was carried out which showed vegetations affecting the CRT-D leads (Fig. 1).Figure 1:


Cardiac device-associated lead infection: a diagnosis not to be missed.

Marquette M, Budhdeo S, Rajagopal V, Marinescu M - Oxf Med Case Reports (2015)

(a–d) Transoesophageal echocardiogram images which show a hypoechogenic linear structure which represents the vegetation and not a loop of the pacemaker lead, which would be hyperechogenic. The vegetation is attached to the atrial segment of the pacemaker lead and is distant from other heart structures. The vegetation is indicated with an arrow in (c) and is labelled in (d).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4584490&req=5

OMV014F1: (a–d) Transoesophageal echocardiogram images which show a hypoechogenic linear structure which represents the vegetation and not a loop of the pacemaker lead, which would be hyperechogenic. The vegetation is attached to the atrial segment of the pacemaker lead and is distant from other heart structures. The vegetation is indicated with an arrow in (c) and is labelled in (d).
Mentions: Multiple blood cultures were consistently positive for Staphylococcus aureus. These consisted of three separate sets of blood culture bottles, taken and sent for analysis within the first 24 h of admission. No antibiotic therapy was started at this stage. Two sets of blood culture bottles were positive. CT pulmonary angiogram showed segmental emboli with a small area of pulmonary infarction. Trans-thoracic echocardiography did not identify any new pathology. Subsequently, trans-oesophageal echocardiography was carried out which showed vegetations affecting the CRT-D leads (Fig. 1).Figure 1:

Bottom Line: His symptoms worsened 2 weeks prior to presentation.He experienced swinging pyrexia, night sweats and shortness of breath on exertion.The patient made a full recovery and a new device was implanted.

View Article: PubMed Central - HTML - PubMed

Affiliation: Peterborough City Hospital , Peterborough PE3 9GZ , UK.

ABSTRACT
A 66-year-old gentleman was admitted to hospital with a history of general malaise for 5 months. His symptoms worsened 2 weeks prior to presentation. He experienced swinging pyrexia, night sweats and shortness of breath on exertion. Initial evaluation did not reveal any source of infection. Subsequent investigation revealed infection with vegetation affecting the intra-cardiac leads of cardiac resynchronization therapy device (CRT-D). The patient was treated with prolonged intravenous antibiotics and removal of the device and indwelling leads. The patient made a full recovery and a new device was implanted.

No MeSH data available.


Related in: MedlinePlus