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KMID : 0191120040190020291
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Journal of Korean Medical Science
2004 Volume.19 No. 2 p.291 ~ p.293
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Pacemaker Lead Endocarditis Caused by Achromobacter xylosoxidans
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Ahn Y
Kim NH/Shin DH/Park OY/Kim W/Jeong MH/Cho JG/Park JC/Kang JC
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Abstract
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We report the case of a 35-yr-old patient who presented with high fever and chills. He had undergone a patch closure of the ventricular septal defect 18 yr before. One year later, a VVI pacemaker was implanted via the right subclavian vein because of complete heart block. Nine years after that, a new VVI pacemaker with another right ventricular electrode was inserted controlaterally and the old pacing lead was abandoned. Trans-thoracic and trans-esophageal echocardiogram identified the pacemaker lead in the right ventricle (RV) attaching hyperechoic materials and also a fluttering round hyperechoic mass with a stalk in the RV outflow tract. Cultures in blood and pus from pacemaker lead grew Achromobacter xylosoxidans. A diagnosis of pacemaker lead endocarditis due to Achromobacter xylosoxidans was made. In this regards, the best treatment is an immediate removal of the entire pacing system and antimicrobial therapy.
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