Two patients with permanent transvenous cardiac pacemakers were seen w
ith a history of pyrexia of unknown origin and renal failure. After ex
tensive investigation both were found to have pacemaker endocarditis.
A renal biopsy of one patient revealed changes characteristic of glome
rulonephritis associated with this condition, Both patients underwent
thoracotomy for open removal of their pacemaker and appropriate antibi
otic treatment. One patient made a good recovery of renal function. Un
fortunately the second patient died. These reports emphasize the need
for vigilance for these two uncommon complications and the difficulty
in their diagnosis.