Key result
Surgical lead extraction plus prolonged antifungal therapy successfully treats Aspergillus pacemaker endocarditis at 1 year.
Why the study?
Fungal pacemaker endocarditis is an extremely uncommon but severe complication of endocardial pacemaker implantation.
Case Report (n=1)
Highlights a rare case of fungal pacemaker endocarditis presenting as pulmonary embolism, successfully managed with surgical extraction and prolonged antifungal therapy.
Consider fungal PME in pacemaker patients with PE; leaves open optimal management strategies.
Pacemaker endocarditis (PME) is a rare but severe complication of endocardial pacemaker implantation. Fungal PME is extremely uncommon. The case of a 66-year-old female patient who was diagnosed as having a pulmonary embolus based upon the patient's clinical presentation and computed tomography angiography findings is presented. Transthoracic echocardiography demonstrated a huge vegetation attached to the pacemaker wire. The pacemaker system was removed surgically during cardiovascular bypass. The vegetation was cultured, the results of which were positive for Aspergillus spp. No risk factors for Aspergillus infection were found in the patient. She was treated with liposomal amphotericin B for 3 weeks, followed by itraconazole for 40 weeks. At 1 year later, the patient remains asymptomatic.
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Mateos-Colino et al. (2005) conducted a case report in Aspergillus pacemaker endocarditis (n=1). Surgical removal and antifungal therapy was evaluated on Clinical status. Surgical removal of the pacemaker system combined with prolonged antifungal therapy successfully treated Aspergillus pacemaker endocarditis, with the patient remaining asymptomatic at 1 year.
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