J Korean Med Sci.  2004 Apr;19(2):291-293. 10.3346/jkms.2004.19.2.291.

Pacemaker Lead Endocarditis Caused by Achromobacter xylosoxidans

• Ahn Y
• Kim NH
• Shin DH
• Park OY
• Kim W
• Jeong MH
• Cho JG
• Park JC
• Kang JC

• KMID: 1733492
• DOI: http://doi.org/10.3346/jkms.2004.19.2.291

Abstract

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.

Keyword

Endocarditis; Pacemaker, Artificial; Achromobacter xylosoxidans

MeSH Terms

*Achromobacter xylosoxidans
Adult
Electrodes, Implanted/microbiology
Endocarditis/microbiology/*ultrasonography
Gram-Negative Bacterial Infections/*ultrasonography
Heart Block/therapy
Human
Male
Pacemaker, Artificial/*microbiology

Figure

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  Fig. 1 (A) Transthoracic echocardiogram, apical four-chamber view. A pacemaker lead with attached hyperechoic materials is seen in the right ventricle. (B) Transesophageal echocardiogram. A hyperechoic mass with a stalk is freely movable in the right ventricular outflow tract.

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  Fig. 2 The removed electrode. It was destroyed and attached with yellow-brown friable materials.

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