Coronary stent infection: Interesting cases with varied presentation

Abstract

Stent infection after drug-eluting stent implantation is uncommon but is a critical event. In this study, we describe two such cases of coronary stent infection but with varied presentation. The first patient presented with recurrent stent thrombosis and acute coronary syndrome while the second patient was erroneously diagnosed as having tubercular pericarditis and was started on anti-tubercular therapy. Due to their possible fatal outcome, we herein report our experience with this uncommon clinical entity to help in rapid diagnosis and treatment. <Learning objective: Infection involving implanted stents is rare, it can, however, occur with high morbidity and mortality. In absence of diagnostic criteria or classic signs and symptoms, one should be aware of its presence and risk factors associated with it. Certain rare conditions such as JAK2 V617F mutation significantly alter hemogram leading to changes in red blood cell, white blood cell, and platelet counts facilitating coronary thrombosis should also be kept in mind.>

Antimicrobial and Antibiofilm Effects of Peptides from Venom of Social Wasp and Scorpion on Multidrug-Resistant Acinetobacter baumannii

“…Cases of vascular stent infections are rare complications, but associated with high mortality rates; according to current data, mortality may reach 40%, despite antibiotic treatment and/or surgical removal [4,5]. The most likely cause of stent infections is equipment reuse, such as balloons, catheters, and guide-wire, or poor ascetical techniques during the procedure [6]. These bacteria from the hospital environment and human skin are the most frequently found in stent infections: Staphylococcus spp.…”

“…These bacteria from the hospital environment and human skin are the most frequently found in stent infections: Staphylococcus spp. [6,7,8], Streptococcus spp. [9], Pseudomonas spp.…”

Prompt CT Diagnosis of Epicardial Coronary Abscess after Percutaneous Coronary Intervention Caused by Klebsiella Pneumoniae

“…The most common cause of coronary stent infection is procedure-related infection from the skin or catheters, often due to Staphylococcus aureus (80%) followed by Pseudomonas aeruginosa (20%). 1) 2) 3) In previous reports, the primary tool to identify coronary stent infection was the identification of pseudoaneurysm formation on coronary angiography. 1) 2) 3) However, coronary angiography only visualizes a portion of the overall abscess pocket.…”

“…1) 2) 3) In previous reports, the primary tool to identify coronary stent infection was the identification of pseudoaneurysm formation on coronary angiography. 1) 2) 3) However, coronary angiography only visualizes a portion of the overall abscess pocket. In contrast, CT can evaluate the overall extent of coronary stent infection, facilitating proper therapeutic planning.…”

Coronary stent infection

“…Less than 30 cases have been reported in the literature since the advent of coronary stents. 1 Compared to other intravascular stents, the prevalence of coronary stent infection is much lower, probably because of high blood flow in the coronary arteries. In reported cases, mortality is high (40–65%) and S. aureus is the most frequently identified pathogen.…”