J Korean Med Sci.  2002 Oct;17(5):691-694. 10.3346/jkms.2002.17.5.691.

Aspergillus Infection in a Large Thrombus of a Permanent Ventricular Pacing Lead

• Kim HY
• Kim CJ
• Rho TH
• Youn HJ
• Cho EJ
• Jin SW
• Jeon HK
• Chae JS
• Kim JH
• Hong SJ
• Choi KB

• KMID: 1127265
• DOI: http://doi.org/10.3346/jkms.2002.17.5.691

Abstract

Pacemaker lead infection is a rare but a dangerous complication. Diagnosis can usually be established by the clinical picture and blood cultures. Transesophageal two dimensional echocardiography might be crucial in the diagnosis by visualizing pacing lead vegetations. Medical treatment alone is rarely successful, and several studies have suggested the infected pacemaker systems should be removed quickly for optimal management. We describe a case of Aspergillus infection in a permanent ventricular pacing lead, which appears to be the first reported case in Korea. A 30-yr-old man was evaluated for the symptoms and signs of congestive heart failure 3 yr after DDD pacemaker implantation. The transthoracic and transesophageal echocardiogram showed a large movable round shaggy mass attached to a ventricular lead in the right atrium. The atrial and ventricular leads were removed during cardiopulmonary bypass, and a new epicardial pacing system was implanted. The functional ventricular pacemaker lead was encased in a large organized thrombus. Histological findings were consistent with Aspergillus infection in a large thrombus attached to a pacemaker lead.

Keyword

Aspergillus; Pacemaker; Artificial; Echocardiography

MeSH Terms

Adult
Aspergillosis/diagnosis/*etiology/microbiology
Echocardiography
Echocardiography, Transesophageal
Heart Atria/microbiology
Humans
Male
Pacemaker, Artificial/*adverse effects/microbiology
Thrombosis/diagnosis/*etiology/microbiology