Severe pacemaker pocket infection during the COVID-19 pandemic, transvenous lead removal

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.

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Esha M. Kapania ◽  
Christina Link ◽  
Joshua M. Eberhardt

Background. Chilaiditi syndrome is a phenomenon where there is an interposition of the colon between the liver and the abdominal wall leading to clinical symptoms. This is distinct from Chilaiditi sign for which there is radiographic evidence of the interposition, but is asymptomatic. Case Presentation. Here, we present the case of a patient who, despite having clinical symptoms for a decade, had a delayed diagnosis presumably due to the interposition being intermittent and episodic. Conclusions. This case highlights the fact that Chilaiditi syndrome may be intermittent and episodic in nature. This raises an interesting question of whether previous case reports, which describe complete resolution of the syndrome after nonsurgical intervention, are perhaps just capturing periods of resolution that may have occurred spontaneously. Because the syndrome may be intermittent with spontaneous resolution and then recurrence, patients should have episodic follow-up after nonsurgical intervention.


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.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Fahad H. Abduljabbar ◽  
Abdulaziz Aljurayyan ◽  
Bayan Ghalimah ◽  
Lawrence Lincoln

Introduction. Simultaneous bilateral quadriceps tendon ruptures (SBQTR) are uncommon knee injuries and most frequently occur in male patients, over 50 years of age. It can be associated with one or more predisposing risk factors like obesity, steroids use, and hyperparathyroidism. The main focus of this paper is to review SBQTR in obese patients. Case Report. We are reporting the youngest patient in the literature to date, a 24-year-old obese male patient, who presented to the emergency department complaining of bilateral knee pain and inability to walk after a fall during a basketball game. His clinical examination revealed the presence of a palpable suprapatellar gap and loss of knee extension bilaterally. Magnetic resonance imaging (MRI) confirmed that both of his quadriceps tendons were ruptured. A day after his diagnosis, the patient underwent successful operative repair followed by rehabilitation. At the two-year follow-up, the patient had full strength of both quadriceps muscles with no extension lag. Conclusion. The diagnosis of SBQTR can be challenging. Early diagnosis and treatment are associated with better functional outcome compared to delayed treatment. Physicians should have a high index of clinical suspicion in order not to miss such an injury and achieve favourable outcomes.


2019 ◽  
Vol 2 (1-3) ◽  
pp. 89-93
Author(s):  
Cláudia Vale ◽  
André Carvalho ◽  
Tiago Roseiro ◽  
João Antunes ◽  
Óscar Tellechea ◽  
...  

We present a case report of a digital papillary adenocarcinoma (DPA) on the left thumb with slow growth that was completely excised, without recurrence or metastasis during 24-month follow-up. DPA is a rare malignant tumor often located on the digits of the hand. Due to its slow growth and a non-specific appearance, the diagnosis is often missed or delayed. Treatment should be surgical with clear resection of the margins due to high risk of recurrence and/or metastasis.


Author(s):  
C Lucero ◽  
F Díaz-Dilernia ◽  
F Comba ◽  
G Zanotti ◽  
F Piccaluga ◽  
...  

Case We present a case of a 70-year-old woman with simultaneous periprosthetic joint infection (PJI) of both hips and left knee due to a bilateral psoas abscess. The patient underwent debridement and implants removal with the consequent reimplantation in a sequential six-stage revision surgery. At four years of follow-up and in spite of the patient’s comorbidities and current PJI presentation, she maintains full activities of daily living without restrictions. Conclusion Accurate and early diagnosis of a psoas abscess is crucial. This case report provides experience of a complex scenario, the decision-making involved and the outcomes of an underdiagnosed complication.


2015 ◽  
Vol 4 (1) ◽  
pp. 49
Author(s):  
Erica deAvila ◽  
Rafael deMolon ◽  
Mario Gabrielli ◽  
Eduardo HochuliVieira ◽  
Marisa Gabrielli

2017 ◽  
Vol 4 (10) ◽  
pp. 3511
Author(s):  
Paa Kwesi Baidoo ◽  
Boniface Adegah

Though uncommon, cases of traumatic hip dislocation have been reported in children worldwide. Averagely, it is recommended that the acceptable duration for reduction after such dislocations is about 6 hours. Even with that there is about 5% documented chance of developing avascular necrosis of the head of the femur. The incidence of avascular necrosis increases with delayed relocation of the femoral head. We report a case involving a 6-year-old girl with a 2-week delayed diagnosis of a left posterior hip dislocation that was reduced and followed up for 6 years.


2021 ◽  
Vol 8 ◽  
Author(s):  
Qihua Wang ◽  
Rami W. A. Alshayyah ◽  
Hang Lv ◽  
Yang Yu ◽  
Xinyu Liu ◽  
...  

Traumatic testicular dislocation is a rare complication secondary to different kinds of accidents. A 61-year-old man, who was injured by wall collapse and was diagnosed as pelvic fracture and posterior urethral rupture 5 months ago, came to the urologic department to seek urethral reconstruction. However, thorough physical examination and imaging examination confirmed a round mass in the right inguinal region and an empty right scrotum, which support diagnosis of testicular dislocation. The patient did not take the initiative to complain about that because he thought the right testis had been destroyed by the accident already. So the patient underwent fiber cystourethroscopy, urethral reconstruction, and orchiopexy. No testicular atrophy was confirmed at follow-up. We reviewed previous reports about traumatic testicular dislocation and analyzed the cause of delayed diagnosis.


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