Infective endocarditis following incomplete removal of a pacemaker

Pacemaker lead-related infective endocarditis is uncommon but mortality rem ains high. We report the case of a 63-year-old man who presented with a history of int ermittent low-grade fever and no other sign for 15 months. Fever had develo ped after incomplete removal of a pacemaker with the ventricular lead Left in situ followed by a new implantation of cardiac stimulation material. Pos itive blood cultures and transesophageal echocardiography showing a vegetat ion on a pacemaker lead gave the diagnosis, initial antibiotic therapy was insufficient and complete surgical extraction of the pacemaker and leads wa s required, A huge vegetation was seen on the old ventricular lead, The oth er Leads were not affected, Outcome was good.d The paucity of symptoms in pacemaker lead-related infective endocarditis ma kes diagnosis difficult. it must however be suspected in pacemaker patients with low-grade intermittent fever. Transesophageal echocardiography is req uired. Treatment must combine antibiotic therapy with material extraction.