A 46-year-old man with type 1 diabetes developed persistent Staphylococcus aureus bacteremia, septic arthritis, and pacemaker lead endocarditis originating from a flash glucose monitor insertion site.
Case Report (n=1)
Flash glucose monitor insertion-site infections can lead to severe systemic complications, including pacemaker lead infective endocarditis, emphasizing the need for early recognition and aggressive management in high-risk patients.
Flash glucose monitoring (FGM) systems are widely used in diabetes care, although cutaneous complications remain uncommon. However, FGM insertion-site infections can serve as a portal for Staphylococcus aureus, potentially leading to systemic complications in high-risk patients. We report the case of a 46-year-old man with poorly controlled type 1 diabetes who presented with fever, confusion, and cellulitis at an FGM site. Cultures confirmed persistent S. aureus bacteremia. Imaging revealed deep glenohumeral joint infection requiring surgical washout. Despite an initially normal transthoracic echocardiogram, persistent bacteremia prompted transesophageal echocardiography, which demonstrated a pacemaker lead vegetation. He underwent complete device extraction and received prolonged IV flucloxacillin. This case highlights the potential for FGM-site infections to progress to septic arthritis and pacemaker lead infective endocarditis, emphasizing early recognition and aggressive management.
Linn et al. (Fri,) conducted a case report in Pacemaker lead endocarditis and Staphylococcus aureus bacteremia (n=1). Pacemaker system extraction and IV antibiotics was evaluated. A 46-year-old man with type 1 diabetes developed persistent Staphylococcus aureus bacteremia, septic arthritis, and pacemaker lead endocarditis originating from a flash glucose monitor insertion site.