scholarly journals Rare enough ? Cardiac Device‐related pocket Infection due to Mycobacterium fortuitum

2021 ◽  
Author(s):  
Reshma Golamari ◽  
Nitasa Sahu ◽  
Rama Vunnam ◽  
Dhirisha Bhatt ◽  
Rameet Thapa ◽  
...  
2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
A. F. Lazo-Vasquez ◽  
J. A. Gonzales-Zamora

Mycobacterium peregrinum is a rapidly growing mycobacterium (RGM), subspecies of Mycobacterium fortuitum complex, which can cause infections in the skin, surgical sites, and central lines. It has also been associated with implantable devices such as cardiac devices. Our objective is to present an atypical clinical case of M. peregrinum infection associated with a cardiac device, review the published literature, and highlight the importance of this type of RGM infection to enhance their therapeutic success. Only two other cases have been reported of M. peregrinum infection associated with cardiac devices. Diagnosis and treatment of Mycobacterium peregrinum infection can be challenging, and the literature is scarce. Better understanding and further research should be conducted regarding this infection.


2020 ◽  
Author(s):  
Reshma Golamari ◽  
Nitasa Sahu ◽  
Rama Vunnam ◽  
Ramesh Thapa ◽  
Ravi Patel ◽  
...  

2020 ◽  
Author(s):  
Reshma Golamari ◽  
Nitasa Sahu ◽  
Rama Vunnam ◽  
Dhirisha Bhatt ◽  
Rameet Thapa ◽  
...  

2021 ◽  
Vol 15 (09) ◽  
pp. 1277-1280
Author(s):  
Milos Dusan Babic ◽  
Lazar Angelkov ◽  
Milosav Tomovic ◽  
Mihailo Jovicic ◽  
Darko Boljevic ◽  
...  

Introduction: The estimated infection rate after permanent endocardial lead implantation is between 1% and 2%. Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. In this case report, we present a patient with delayed diagnosis and treatment due to the COVID-19 outbreak. Case Report: An 88-year-old, pacemaker dependent woman with diagnosed pacemaker pocket infection was admitted to the University Cardiovascular institute. The patient had a prolonged follow-up time due to the COVID-19 outbreak. She missed her routine checkup and came to her local hospital when the generator had already protruded completely, to the point where she held it in her own hand. Transthoracic echocardiogram showed possible vegetations on the lead. Transesophageal echocardiography was not performed due to the COVID-19 pandemic. On the day after the admission the patient underwent transvenous removal of the pacemaker lead using a 9 French gauge rotational extraction sheathe (Cook Medical). The extracted lead was covered in a thin layer of vegetations. Further follow-ups showed good recovery with no complications. Conclusions: A case showing delayed treatment of pacemaker pocket infection, due to delayed follow-up time during the COVID-19 pandemic. This patient underwent successful transvenous removal of the infected pacemaker lead, along with adequate antibiotic therapy, which has proven to be the most effective method of treating cardiac device-related endocarditis.


2021 ◽  
Vol 9 (B) ◽  
pp. 909-916
Author(s):  
Hend Yahia ◽  
Abdo Alazab ◽  
Randa Aly ◽  
Sameh Elmaraghi ◽  
Ashraf Andraos

Background:  It has been demonstrated that the use of cardiac implanted electronic devices (CIED) improve mortality and survivability in a variety of patient populations. Nevertheless, CIED related infection is a serious complication characterized by a high rate of mortality and morbidity. Objectives: To evaluate the prevalence of CIED related infections, risk factors, clinical and demographic characteristics, causative organisms, and the management and outcome of patients presented in the Critical Care Department, Cairo University. Methods: A retrospective analysis was conducted in 1871 individuals who had been implanted with a cardiac device with a total number of devices of 1968 and 2270 procedures performed from January 2007 to December 2017. Results: 59 infectious episodes were identified with an estimated incidence of 2.99% of inserted devices and 2.6% of total procedures.  The infection rate was considerably higher in patients with multiple procedures than those who had a single procedure (9.27% vs. 1.18%; P<0.001). The individuals with a dual-chamber implantable cardiac defibrillator (ICD) and cardiac resynchronization therapy devices (CRTD) had the highest infection rate of 6.25% & 6.85%, respectively. The rate of pocket infection (PI) and CIED related endocarditis (CDE) was 1.54% & 1.06% of total devices respectively.  Numerous risk factors have been found; the most significant of those are diabetes mellitus, recurrent procedures, the device's complexity, and the existence of more than one lead. Gram-positive cocci were the most isolated organisms in all positive cultures (69.23%). Echocardiography revealed lead vegetations and valvular vegetations in 22 patients and 2 patients respectively.  In 53 cases (89.83%), the devices were removed; in 41 cases, the entire system was removed; and in 12 cases, only the generator was removed. The mortality rate was found to be 10.17%, having a considerably higher prevalence in CDE individuals than in pocket infection individuals (20.83% vs. 2.86%; P=0.025). Conclusion: In our center, while the rate of CIED implantation continues to increase, the incidence rate of CIED-related infection continues to decline. Until now, the infection burden associated with secondary intervention is still significantly high.  The management strategy of selection is to eliminate the entire system for patients presented with infection especially those with CDE. However, the mortality rate is still high.


2005 ◽  
Vol 16 (3) ◽  
pp. 183-185 ◽  
Author(s):  
Marion Hemmersbach-miller ◽  
Miguel A Cardenes-Santana ◽  
Alicia Conde-Martel ◽  
José A Bolanos-Guerra ◽  
María I Campos-Herrero

Two cases of cardiac device infection due toMycobacterium fortuitumare reported along with a discussion of their clinical management. Long-term therapy and removal of the infected device is needed. The slow progression and absence of systemic signs and symptoms suggest a low pathogenicity ofM fortuitum.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S422-S422
Author(s):  
Sandhya Nagarakanti ◽  
Eliahu Bishburg ◽  
Anita Bapat

Abstract Background Cardiovascular implantable electronic device (CIED) such as pacemaker (PPM) and automated implantable cardiac defibrillator (AICD) are commonly utilized in clinical practice. Definitions of device infection (DI) and guidelines for the work up and device extraction (DE) have been published by the American Heart Association and the Infectious Disease Society of America. Our objective was to evaluate whether the work up of DI as recommended was followed, and whether the device was extracted according to guidelines. Methods A retrospective review in a 680-bed tertiary care hospital. Adult patients (patients) >18 years. who were diagnosed as having a DI and had the device extracted between 2008 and 2017 were included. Data were collected on demographics, device duration, blood culture (BC), echocardiogram utilization, lead cultures (LC) and device pocket cultures, appropriateness of extraction as per guidelines. Results Ninety-five patients were included. Mean age 68 years (range 23–90). 67 (70%) were male. Devices included: AICD in 75 (79%), PPM in 20(21%). CIED was present <1 year prior to infection in 24(24%). Compliance with guidelines recommendation to draw blood cultures, obtain an echocardiogram and send lead cultures and device pocket cultures were seen in 100%, 90.5% and 49.4% and 67.7%, respectively. Criteria for extraction was met in 65/95 (69%); reason for extraction was a pocket infection in 16/65(24.6%), bacteremia in 49/65 (75%), infective endocarditis in 38/65(58%). Thirty (31.5%) had device extracted without meeting guidelines recommendation, in 17 a diagnosis of pocket infection but without microbiological criteria or clinical diagnosis. In 9 patients lead vegetations were seen but no cultures to support extraction. Mortality was seen in 4 patients, one during the extraction procedure. Conclusion In our institution, 1/3 of the patients diagnosed with DI had no indication for DE. Guidelines recommendation for CIED extraction should be followed as extraction could be associated with significant complications. In this study, overall compliance with guidelines work up recommendations were not consistently followed, especially LC and device pocket cultures. Disclosures All authors: No reported disclosures.


Author(s):  
Yahya Shabi ◽  
David Haldane ◽  
Paul Bonnar

Mycobacterium fortuitum is a rapidly growing mycobacterium, ubiquitous in soil and water, but it is an uncommon cause of infections in immunocompetent hosts. Cardiac device infections and bloodstream infections due to non-tuberculous mycobacteria are rare. We present the case of an 85-year-old patient with infective endocarditis and pacemaker lead infection secondary to M. fortuitum.


2010 ◽  
Vol 6 (3) ◽  
pp. 87
Author(s):  
Niraj Varma ◽  

The use of implantable electronic cardiac devices is increasing. Post-implantation follow-up is important for monitoring both device function and patient condition; however, clinical practice is inconsistent. For example, implantable cardioverter–defibrillator follow-up schedules vary from every three months to yearly according to facility and physician preference and the availability of resources. Importantly, no surveillance occurs between follow-up visits. By contrast, implantable devices with automatic remote monitoring capability provide a means for performing constant surveillance, with the ability to identify salient problems rapidly. The Lumos-T Reduces Routine Office Device Follow-up Study (TRUST) demonstrated that remote home monitoring reduced clinic burden and allowed early detection of patient and/or system problems, enabling efficient monitoring and an opportunity to enhance patient safety. The results of the trial have significant implications for the management of patients receiving all forms of implantable electronic cardiac device.


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