Abstract
Pacemaker associated infection (PAI) is a rare but often serious complication of permanent or temporary transvenous cardiac pacemakers. The major risk factor is recent or multiple pacemaker manipulations or surgical procedures. A PAI can occur at the time of insertion, from contiguous spread to the access site, or from transient bacteremia. We report a case of PAI of a retained pacemaker electrode from which a Corynebacterium species was isolated. Multiple preoperative cultures were sterile, but bacteria were isolated from tissue removed at surgery, and were seen around the wire deep inside a thrombus. The importance of cultures and special stains (including electron microscopy) of surgical materials is stressed, especially when dealing with microorganisms of ordinarily low virulence, or those that are commonly considered laboratory contaminants.
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- Choo M. H., Holmes D. R., Jr, Gersh B. J., Maloney J. D., Merideth J., Pluth J. R., Trusty J. Permanent pacemaker infections: characterization and management. Am J Cardiol. 1981 Sep;48(3):559–564. doi: 10.1016/0002-9149(81)90088-6. [DOI] [PubMed] [Google Scholar]
- Fishbein M. C., Tan K. S., Beazell J. W., Schulman J. H., Hirose F. M., Criley J. M. Cardiac pathology of transvenous pacemakers in dogs. Am Heart J. 1977 Jan;93(1):73–81. doi: 10.1016/s0002-8703(77)80174-9. [DOI] [PubMed] [Google Scholar]
- Garrison P. K., Freedman L. R. Experimental endocarditis I. Staphylococcal endocarditis in rabbits resulting from placement of a polyethylene catheter in the right side of the heart. Yale J Biol Med. 1970 Jun;42(6):394–410. [PMC free article] [PubMed] [Google Scholar]
- Gronemeyer P. S., Weissfeld A. S., Sonnenwirth A. C. Corynebacterium group JK bacterial infection in a patient with an epicardial pacemaker. Am J Clin Pathol. 1980 Dec;74(6):838–842. doi: 10.1093/ajcp/74.6.838. [DOI] [PubMed] [Google Scholar]
- Lipsky B. A., Goldberger A. C., Tompkins L. S., Plorde J. J. Infections caused by nondiphtheria corynebacteria. Rev Infect Dis. 1982 Nov-Dec;4(6):1220–1235. doi: 10.1093/clinids/4.6.1220. [DOI] [PubMed] [Google Scholar]
- Morgan G., Ginks W., Siddons H., Leatham A. Septicemia in patients with an endocardial pacemaker. Am J Cardiol. 1979 Aug;44(2):221–224. doi: 10.1016/0002-9149(79)90308-4. [DOI] [PubMed] [Google Scholar]
- Murray B. E., Karchmer A. W., Moellering R. C., Jr Diphtheroid prosthetic valve endocarditis. A study of clinical features and infecting organisms. Am J Med. 1980 Dec;69(6):838–848. doi: 10.1016/s0002-9343(80)80009-x. [DOI] [PubMed] [Google Scholar]
- Parsonnet V., Zucker I. R., Kannerstein M. L., Ilbert L., Alvares J. F. The fate of permanent intracardiac electrodes. J Surg Res. 1966 Jul;6(7):285–292. doi: 10.1016/s0022-4804(66)80039-2. [DOI] [PubMed] [Google Scholar]
- Robboy S. J., Harthorne J. W., Leinbach R. C., Sanders C. A., Austen W. G. Autopsy findings with permanent pervenous pacemakers. Circulation. 1969 Apr;39(4):495–501. doi: 10.1161/01.cir.39.4.495. [DOI] [PubMed] [Google Scholar]
- Siddons H., Nowak K. Surgical complications of implanting pacemakers. Br J Surg. 1975 Dec;62(12):929–935. doi: 10.1002/bjs.1800621202. [DOI] [PubMed] [Google Scholar]
- Van Scoy R. E., Cohen S. N., Geraci J. E., Washington J. A., 2nd Coryneform bacterial endocarditis: difficulties in diagnosis and treatment, presentation of three cases, and review of literature. Mayo Clin Proc. 1977 Apr;52(4):216–219. [PubMed] [Google Scholar]