Article thumbnail

Aspergillus infection in a large thrombus of a permanent ventricular pacing lead.

By Hee-Yeol Kim, Chong-Jin Kim, Tai-Ho Rho, Ho-Joong Youn, Eun-Ju Cho, Seung-Won Jin, Hui-Kyung Jeon, Jang-Seong Chae, Jae-Hyung Kim, Soon-Jo Hong and Kyu-Bo Choi

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

Topics: Research Article
Publisher: Korean Academy of Medical Sciences
OAI identifier: oai:pubmedcentral.nih.gov:3054926
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles

Citations

  1. (1984). Aspergillus infection of a permanent pacing lead. Pacing Clin Electrophysiol
  2. (1974). Aspergillus species endocarditis.
  3. (1981). Bacterial endocarditis and right atrial vegetation: detection by two-dimensional echocardiography. JAMA
  4. (1972). Cardiac pathology of transvenous pacemakers.
  5. (1985). Disseminated aspergillosis and pacemaker endocarditis. Pacing Clin Electrophysiol
  6. (1978). Dynamic tricuspid valve insufficiency produced by right venticular thrombus from a pacemaker. Chest
  7. (1978). Endocarditis related to transvenous pacemakers. J Thorac Cardiovasc Surg
  8. (1986). Management of infected pacemaker system. Clin Prog Pacing Electrophysiol
  9. (1985). Pacemaker infections: treatment with total or partial pacemaker system removal. Thorac Cardiovasc Surg
  10. (1996). Pacemaker lead infection: detection by multiplane transesophageal echocardiography.
  11. (1981). Permanent pacemaker infections: characterization and management.
  12. (1991). Removal of implanted hardware. Pacing Clin Electrophysiol
  13. (1998). Role of transesophageal echocardiography in the diagnosis of infected retained pacing lead. Pacing Clin Electrophysiol
  14. (1993). Sustained bacteremia in 26 patients with a permanent endocardial pacemaker: assessment of wire removal. Clin Infect Dis
  15. (1997). Systemic infection related to endocarditis on pacemaker leads. Clinical presentation and management. Circulation
  16. (1983). Thrombotic complication with pacemakers.
  17. (1985). Update on infections involving permanent pacemakers: characterization and management.
  18. (1990). Use of noninvasive cardiac diagnostic techniques in patients with cardiac pacemakers.
  19. (1982). Usefulness of echocardiography in cardiac pacing. Pacing Clin Electrophysiol