Diagnosis and Management of Infections Involving Implantable Electrophysiologic Cardiac Devices

Chua, Jimmy; Wilkoff, Bruce L.; Lee, Irene; Juratli, Nour; Longworth, David L.; Gordon, Steven M.

doi:10.7326/0003-4819-133-8-200010170-00011

Cited by 454 publications

(411 citation statements)

References 17 publications

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“…Pacemaker infections occurred in 38 patients (2.9%). As previously described, 4 most pacemaker infections were due to Staphylococcus epidermidis, Staphylococcus aureus, and Gram-negative enteric bacilli. Of note, 2 of the 38 cases were due to Aspergillus infection.…”

Section: Resultssupporting

confidence: 58%

Pacemaker infection due to Aspergillus: report of two cases and literature review

Izquierdo¹,

Llorente²,

Mayo

et al. 2005

Clinical Cardiology

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SummaryBackground: Aspergillus infections of pacing systems are extremely uncommon, and most cases reported are characterized by an aggressive behavior that may lead to death of the patient.Hypothesis: The study was undertaken to assess the incidence of pacemaker infection due to Aspergillus in a defined population.Methods: A retrospective review of the case histories of all patients who underwent pacemaker implantation in the reference center for a defined population over a 13-year period was undertaken. A literature review of pacemaker infections due to Aspergillus was conducted.Results: Of the 1,321 patients who required pacemaker implantation at Hospital Xeral-Calde in the Lugo region of northwestern Spain, 38 suffered a pacemaker infection. A pacemaker pocket infection due to Aspergillus fumigatus was found in two patients. Both patients had a previous history of diabetes mellitus. Cultures from pacemaker pocket inflammatory fluid yielded positive results. Following pacemaker explantation and antifungal therapy, clinical improvement was achieved. A literature review showed another five cases of pacemaker infection due to Aspergillus. However, two peculiarities were found in our patients: In both cases an etiological diagnosis was achieved prior to surgery and, to the best of our

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Section: Resultssupporting

confidence: 58%

Pacemaker infection due to Aspergillus: report of two cases and literature review

Izquierdo¹,

Llorente²,

Mayo

et al. 2005

Clinical Cardiology

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“…13,14 This reflects the increasing size of the problem because more and more pacemakers and ICDs are implanted in the United States. 4 However, to our knowledge, few of these studies have investigated the risk factors for infection by means of a casecontrol study.…”

Section: Discussionmentioning

confidence: 99%

Case-Control Study of Surgical Site Infections Associated With Pacemakers and Implantable Cardioverter-Defibrillators

Marschall

Hopkins-Broyles

Jones

et al. 2007

Infect. Control Hosp. Epidemiol.

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“…Rapidly growing mycobacteria are not usually pathogenic for humans but they can cause several type of infections including skin and soft tissue infections, osteomyelitis, lymphadenitis, disseminated disease, meningitis, postsurgical wound infections, infections of prostethic devices, and chronic lung disease (3)(4)(5)(6)(7)(15)(16)(17)(18). Some cases have been described in Colombia (8,11).…”

Section: Discussionmentioning

confidence: 99%

“…Non-tuberculous mycobacteria colonization and infection of intracardiac devices such as prosthetic valves, catheters, pacemaker wires or defibrillators have been known for long time (15)(16)(17)(18). The presence in water sources and soil favors the colonization and infection of predisposed patients.…”

Section: Discussionmentioning

confidence: 99%

Micobacteriosis diseminada con compromiso de válvula aórtica protésica: primer caso de Mycobacterium peregrinum de tipo III reportada en Colombia

Torres‐Duque¹,

Diaz²,

Vargas³

et al. 2011

biomedica

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Rapidly growing mycobacteria are non-tuberculous mycobacteria amply present in the environment. Although they are not usually pathogenic for humans, they are opportunistic in that they can cause disease in people with disadvantageous conditions or who are immunocompromised. Mycobacterium peregrinum, an opportunistic, rapidly growing mycobacteria, belongs to the M. fortuitum group and has been reported as responsible for human cases of mycobacteriosis. A case of M. peregrinum type III is herein reported as the first in Colombia. It presented as a disseminated disease involving a prosthetic aortic valve (endocarditis) in a seventeen-year-old girl with a well-established diagnosis of prosthetic aortic valve endocarditis who was referred for a surgical replacement. Due to a congenital heart disease (subaortic stenosis with valve insufficiency), she had two previous aortic valve implantation surgeries. One year after the second implantation, the patient presented with respiratory symptoms and weight lost indicative of lung tuberculosis. A chest X-ray did not show parenchymal compromise but several Ziehl-Neelsen stains were positive. An echocardiography showed a vegetation on the prosthetic aortic valve. In blood and sputum samples, M. peregrinum type III was identified through culture, biochemical tests and hsp65 gene molecular analysis (PRA). The patient underwent a valve replacement and received a multidrug antimycobacterial treatment. Progressive recovery ensued and further samples from respiratory tract and blood were negative for mycobacteria.Key words: Mycobacterium, Mycobacterium peregrinum infections, aortic valve, endocarditis, Colombia. Micobacteriosis diseminada con compromiso de válvula aórtica protésica: primer caso de Mycobacterium peregrinum de tipo III reportada en ColombiaLas micobacterias de rápido crecimiento son microorganismos pertenecientes a las micobacterias no tuberculosas que tienen amplia distribución ambiental. Aunque usualmente no son patógenas para los humanos, en condiciones desfavorables, pueden causar enfermedad en la población general o en huéspedes inmunocomprometidos, por lo cual se consideran oportunistas. Mycobacterium preregrinum es una micobacteria de rápido crecimiento perteneciente al complejo fortuitum que ha sido reportado como responsable de casos de micobacteriosis en humanos. Se presenta el caso de una micobacteriosis por M. peregrinum de tipo III, el primero reportado en Colombia, en una paciente de 17 años de edad con una endocarditis de una válvula aórtica protésica, implantada inicialmente por estenosis subaórtica congénita con insuficiencia y, posteriormente, por estenosis aórtica relacionada con la válvula inicialmente implantada. Un año después del segundo implante, presentó sintomas respiratorios y pérdida de peso sugestivos de tuberculosis pulmonar. Las coloraciones de Ziehl-Neelsen del esputo fueron positivas aunque la radiografía de tórax no mostró compromiso del parénquima. En el ecocardiograma se encontró una vegetación en la válvula aórtica. En las muestras...

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Diagnosis and Management of Infections Involving Implantable Electrophysiologic Cardiac Devices

Abstract: For infections related to implantable electrophysiologic devices, complete device removal and antimicrobial therapy allow timely, successful reimplantation at a remote anatomic site without substantial risk for operative mortality or recurrent infection.

Cited by 454 publications

References 17 publications

Pacemaker infection due to Aspergillus: report of two cases and literature review

Pacemaker infection due to Aspergillus: report of two cases and literature review

Case-Control Study of Surgical Site Infections Associated With Pacemakers and Implantable Cardioverter-Defibrillators

Micobacteriosis diseminada con compromiso de válvula aórtica protésica: primer caso de Mycobacterium peregrinum de tipo III reportada en Colombia

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