Cardiac implantable electronic device infection caused by Gordonia terrae: a case report and literature review

Gordonia terrae is a rare opportunistic pathogen and an uncommon cause of cardiac implantable electronic device (CIED) infection. Herein, we report the first case of CIED infection caused by G. terrae in mainland China and review the literature. A 29-year-old man presented with recurrent skin breakdown, erythema, and sinus tract formation at the pacemaker pocket following device implantation. Culture of pocket tissue yielded G. terrae, which was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and confirmed by 16S rRNA gene sequencing. The patient underwent complete removal of the pacemaker leads and hardware with pocket debridement, followed by intravenous vancomycin and oral linezolid for a total treatment duration of approximately five weeks. The wound healed without recurrence during follow-up. This case broadens the clinical spectrum of G. terrae infection, highlights the importance of microbiological identification techniques for diagnosing rare device-associated infections, and supports complete device removal combined with individualized antimicrobial therapy.