Permanent pacemaker-associated Actinomycetemcomitans endocarditis: A case report

Abstract

Aggregatibacter actinomycetemcomitans is a Gram-negative bacillus, member of the HACEK group of bacteria, and it is a very rare cause of endocarditis. It is also an extremely rare cause of device-associated infection of the heart. We describe the case of a 25 year-old man who presented with pacemaker-associated endocarditis due to Aggregatibacter actinomycetemcomitans and also discuss the implications and treatment of this organism.

Aggregatibacter actinomycetemcomitans pacemaker lead infection—A case report and literature review

“…There is one published case report that describes a similar infection with the same organism as our patient; a young male in his twenties who had a pacemaker, and presented with a febrile illness with positive peripheral blood cultures for A. actinomycetemcomitans . In this case, there was an attempt at antibiotic treatment only, but the patient subsequently developed a relapsed infection and eventually had his device removed, followed by outpatient cefepime with vancomycin, and achieved complete recovery 6 . A second case report describes an Aggregatibacter aphrophilus pacemaker infection, who also similarly required device removal followed by 4 weeks of intravenous ceftriaxone for curative management 7 .…”

PulmonaryAggregatibacter actinomycetemcomitansinfection masquerades as malignancy in a patient with periodontitis

“…Pulmonary abscesses can occur in patients with risk factors conventionally implicated in lung cancer development and can exhibit a seemingly malignant radiographic appearance, including destruction of surrounding structures. [1][2][3][4][5] This is compounded by the fact that pulmonary infections, including those caused by Aa, can demonstrate elevated metabolic activity on PET-CT, which is frequently employed to identify cancerous processes on the basis of high FDG uptake. 4 5 As Aa is rarely implicated in the formation of pulmonary abscesses, more common oral microbes that could have resulted in this presentation include Streptococci sp, anaerobes, Gemella sp and Klebsiella pneumoniae.…”

Pacemaker lead-related endocarditis withNeisseria sicca

“…Other gram-positive bacteria, including streptococci and enterococci, are more rare aetiologies 2. Even more uncommonly, infection from fungi and from gram-negative bacteria, including the HACEK organisms ( Haemophilus , Aggregatibacter , Cardiobacterium , Eikenella and Kingella spp), has been documented 2 8–10. Case reports of implanted cardiac device infection and endocarditis by Pseudomonas , Burkholderia and Mycobacterium species have also been reported6 11 12 (figure 1).…”

“…Per our review of the literature, estimated percentage of cardiac implantable electronic device-associated endocarditis cases induced by several causative organisms 4–12…”