Table 2 Mycobacterial infections of implanted pacemakers as reported in literature
Author | Year | Age | Gender | Procedure/Type of device | Type of infection | Time from procedure | Organism | Clinical presentation | Management/Outcome |
|---|---|---|---|---|---|---|---|---|---|
Amin et al. [17] | 1991 | 21 | F | PM generator change at the age of 20 years (PM at the age of 7 years) | Pocket and proximal leads | 4 months | M. avium complex | Fever, pain, and swelling over the implant site | Device extracted by thoracotomy plus antimicrobial therapy (INH, RIF, ETH for 2 weeks) |
Doherty et al. [18] | 1996 | 70 | F | VVI PM | 10 years | M. tuberculosis (Miliary TB) | Purulent discharge from the pocket and pyrexial illness | Died on her 31st hospital day due to renal and respiratory failure and recurrent VF | |
Cutay et al. [19] | 1998 | 68 | M | CABG surgery and epicardial pacing leads | Pocket and epicardial leads | 20 years | M. abscessus | Erythema and discharge from the pocket site | Device extracted, and antimicrobial therapy (CLR, FOX, AMK for 5 weeks). Patient died about 1 month later due to ESRD |
Verghese et al. [20] | 1998 | 74 | M | PM | 13 days | M. chelonae, and M.fortuitum | Fever, pain, purulent discharge from PM site | Device extracted, successful eradication with antimicrobial therapy (GEN, OFX for 1 month) | |
Sharma et al. [21] | 2005 | 62 | F | Biventricular PM | Pocket and lead endocarditis Bacteremia | 9 months | M. fortuitum | Fever, chills, and pain at PM site | Device extracted, successful eradication with antimicrobial therapy (DOX, CIP for 6 months) |
Hemmersbach-Miller et al. [22] | 2005 | 72 | M | PM in 2005 | Pocket infection | 2 weeks 1 year later | CoNS and M. fortuitum M. fortuitum | Abscess Subcutaneous nodules and chronic drainage | Device extracted, successful eradication with antimicrobial therapy (CIP then CIP, SXT and CLR then AMK and CIP) for 6 months |
Hellwig et al. [23] | 2005 | 8 | – | Epicardial PM was implanted during CP-A anastomosis surgery New epicardial PM 5 weeks later | Pocket and epicardial leads | 11 months 6 months | M. tuberculosis M. tuberculosis | subcutaneous abscess at PM site Fever, and inflammatory syndrome | Device extraction, successful eradication with antimicrobial therapy (RIF, INH, ETH, and PYR 2 months then isoniazid and rifampicin for another 7 months |
Pastor et al. (Spanish) [24] | 2006 | 80 | M | DDD-R PM | Pocket infection Bacteremia | 18 days (started 1 week before) | M. fortuitum | Fever, malaise, drowsiness, and purulent discharge | Device left in situ, successful eradication with antimicrobial therapy (CIP, CLR for 6 weeks) |
Toda et al. (Japanese) [25] | 2006 | 86 | M | Generator change at 82 years | Pocket Bacteremia | 4 years | M. goodii | Fever | Device extraction, successful eradication with antimicrobial therapy (INH, RIP and LVX) |
Giannella et al. [26] | 2007 | 84 | F | Pacemaker upgrade | 1 month | M. fortuitum | Heart failure, fever, pain and erythema at PM site | Device extraction, successful eradication with antimicrobial therapy (LVX for 3 months) | |
Siu et al. [27] | 2007 | 78 | F | DDD PM then New DDD PM on right side | Endocarditis | 3 months | M. fortuitum | Fever and erosion purulent discharge | Old and new devices extraction, successful eradication (LVX and CLR for 6 months) |
Kestler et al. [28] | 2009 | 80 | F | CABG surgery and epicardial pacing wires | Pocket and leads | 11 months | M. tuberculosis | Painful anterior epigastric mass | Drainage of abscess cavity and the wires were cut in the abdominal cavity (INH, RIF and ETH for 16 weeks, then INH and RFP total of 25 weeks) |
Marchandin et al. [29] | 2009 | 23 | M | A mechanical double valve replacement with epicardial PM | Pocket infection | 8-days | M. goodii | Fever then purulent discharge and wound dehiscence | Antimicrobial treatment (OFX and AMK then DOX) with recovery. PM was not removed |
Al Soub et al. [30] | 2009 | 15 | F | PM generator change | Pocket, leads and myocardium Bacteremia | 2 months | M. fortuitum | Discharge from surgical wound site and localized erythema and fever | Device extraction, successful eradication with antimicrobial therapy (DOX, and CIP for 6 months) |
Kumar et al. [31] | 2014 | a.48 b.70 c.71 | M M F | DDD PM VVI PM CRT-P(pulmonary tuberculosis 15 years back) | Pocket infection Pocket infection | 15 months 18 months 60 months | M. tuberculosis M. tuberculosis M. tuberculosis | Subcutaneous abscess of the PM site Subcutaneous abscess at the PM site Large lump over the pacemaker site | Device left in situ antimicrobial therapy (INH,RIF,ETH for 3 months then INH and RIF for another 9 months) PM pocket debridement and antimicrobial Therapy (INH, RIF, ETH and PYR for 3 months then INH and RIF for another 9 months) PM device was explanted, antimicrobial Therapy (RIF, INH, ETH and PYR) |