AORTIC AND MITRAL-VALVE ENDOCARDITIS FOLL OWING PACEMAKER BED INFECTION

The case of a 76-year-old diabetic patient with known aortic valve scl erosis is reported. One week after implantation of a permanent pacemak er system (indication: 2nd degree AV-block type Mobitz) he developed f ever. Large endocarditic vegetations were found on the aortic and mitr al valve (blood cultures: were positive for Staphylococcus aureus). Al so from the pacemaker bed Staphylococcus aureus was isolated and an an tibiotic treatment including vancomycin was started. Nevertheless the patient developed insufficiencies of both the aortic and mitral valves and became hemodynamically unstable. Due to cerebral embolisms and fu rther deterioration of the patient's overall clinical state the alread y planned operative replacement of the aortic and mitral valve could n ot be performed. The patient died because of left ventricular failure after pacemaker infection which was complicated by endocarditis.