Pacemaker Endocarditis Due to Candida albicans: Case Report and Review

Joly, Véronique; Belmatoug, Nadia; Leperre, Armelle; Robert, Jérôme; Jault, F; Carbon, C; Yéni, Patrick

doi:10.1086/516125

Cited by 35 publications

(38 citation statements)

References 24 publications

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“…Candida spp. account for up to 4.5% of these infections (6,49,120). One study of more than 8,000 procedures noted pacemaker infections in 5.6% and endocarditis in 0.5% of patients, using care- (6).…”

Section: Pacemakersmentioning

confidence: 99%

“…One study of more than 8,000 procedures noted pacemaker infections in 5.6% and endocarditis in 0.5% of patients, using care- (6). Candida pacemaker infections have been described mostly in case reports or as single cases in series (14,49,59,98,115,120), and so the mortality due to these infections is not well assessed. Risk factors for pacemaker infections include malnutrition, malignancy, diabetes mellitus, skin disorders, and steroid or anticoagulant use (52).…”

Section: Pacemakersmentioning

confidence: 99%

“…Pacemaker-related endocarditis represents about 10% of pacemaker infections (49) and most commonly arises from infection of the subcutaneous portion that has tracked intravascularly, seeding the intracardiac electrode. Therefore, pacemaker endocarditis and early PVE have similar microbiological profiles (49).…”

Section: Pacemakersmentioning

confidence: 99%

“…Therefore, pacemaker endocarditis and early PVE have similar microbiological profiles (49). Most infections are caused by Staphylococcus spp.…”

Section: Pacemakersmentioning

confidence: 99%

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Candida Infections of Medical Devices

2004

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The number of indwelling medical devices is escalating, and an increasing proportion of device-related infections are being caused by Candida spp. Candida spp. produce biofilms on synthetic materials, which facilitates adhesion of the organisms to devices and renders them relatively refractory to medical therapy. Management of device-related Candida infections can be challenging. Removal of the infected device is generally needed to establish cure of Candida infections of medical devices. However, since the pathogenesis of Candida bloodstream infection is complicated, more studies are necessary to determine the role of catheter exchange in patients with both gastrointestinal tract mucositis and indwelling catheters. The medical and economic impact of these infections is enormous

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Section: Pacemakersmentioning

confidence: 99%

Section: Pacemakersmentioning

confidence: 99%

Section: Pacemakersmentioning

confidence: 99%

“…Therefore, pacemaker endocarditis and early PVE have similar microbiological profiles (49). Most infections are caused by Staphylococcus spp.…”

Section: Pacemakersmentioning

confidence: 99%

See 2 more Smart Citations

Candida Infections of Medical Devices

2004

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“…Common risk factors for fungal endocarditis include anatomical cardiac abnormalities, cardiothoracic surgery, intravenous drug use, use of indwelling vascular catheters and other invasive monitoring devices, prior antibiotic therapy, prolonged hospitalization and decreased immunocompetence (1,12,13). Repeated surgical procedures on pacemaker systems are the single most important risk factor contributing to pacemaker lead endocarditis (14).…”

Section: Discussionmentioning

confidence: 99%

Aspergillus fumigatus pacemaker lead endocarditis: A case report and review of the literature

Leong¹,

Gannon²,

Childs³

et al. 2006

Canadian Journal of Cardiology

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Fungal endocarditis is an uncommon complication of pacemaker implantation and is associated with high mortality rates (1). Survival is largely dependent on early diagnosis and treatment. However, late diagnosis is common due to the frequency of nonspecific clinical symptoms, negative blood cultures and delays in obtaining appropriate imaging studies. A high index of suspicion for fungal endocarditis should be maintained in individuals with implantable pacemakers and fever of an uncertain source, especially in the context of negative blood cultures. We report a patient with rare pacemaker lead endocarditis due to Aspergillus fumigatus, and review the diagnostic and treatment considerations. CASE PRESENTATIONA 71-year-old man was admitted with a two-week history of chest pain and a one-week history of low-grade fever (less than 39°C). His medical history was significant for myocardial infarction, atrial fibrillation and asystolic arrest, leading to pacemaker insertion 23 years previously. Numerous pacemakerrelated complications had led to five pacemaker revisions. Superior vena cava (SVC) syndrome, secondary to pacemaker lead fibrosis, was treated on two separate occasions with percutaneous catheter dilation and stenting, most recently performed four months before presentation. He was receiving chronic anticoagulation with warfarin, and antiplatelet therapy consisting of acetylsalicylic acid and clopidogrel. He had no history of being immunocompromised.Physical examination revealed a temperature of 38.5°C. Chronic plethora due to longstanding SVC obstruction was observed. There were no cardiac murmurs or extra heart sounds. No stigmata of infectious endocarditis were observed. The remainder of the physical examination was unremarkable. Pertinent laboratory data included a hemoglobin count of 113 g/L, white blood cell count of 3.8×10 9 /L, platelet count of 153×10 9 /L, erythrocyte sedimentation rate of 102 mm/h, C-reactive protein concentration of 163 mg/L and international normalized ratio of 2.8. There was no biochemical or electrocardiographic evidence of myocardial infarction. Multiple blood cultures performed during the patient's sixweek admission were negative and no antimicrobial therapy was initiated. The diagnosis of fungal endocarditis requires a high index of clinical suspicion. Rarely, pacemaker implantation may be a risk factor for the development of fungal endocarditis. A 71-year-old man with a history of multiple transvenous pacemaker manipulations and fever of an uncertain source is described. A diagnosis of culture-negative pacemaker endocarditis was established only after repeat transthoracic echocardiography. Amphotericin B was instituted; however, the patient developed a cerebral infarct and died. Postmortem examination demonstrated Aspergillus fumigatus within a large pacemaker lead thrombus, tricuspid and aortic valve vegetations, and septic pulmonary and renal emboli. The present report describes the clinical and pathological features of a rare case of Aspergillus fumigatus pacemaker lead en...

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Candidiasis

Vázquez¹,

Sobel

2010

Essentials of Clinical Mycology

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Pacemaker Endocarditis Due to Candida albicans: Case Report and Review

Cited by 35 publications

References 24 publications

Candida Infections of Medical Devices

Candida Infections of Medical Devices

Aspergillus fumigatus pacemaker lead endocarditis: A case report and review of the literature

Candidiasis

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