Spondylodiscitis disclosing endocarditis on the endocavitary electrodes of cardiac pacemakers
Bonal, J.; Bouchiat, C.; de Jaureguiberry, J.P.; Duval, J.L.; Carli, P.; Chagnon, A.
Archives des Maladies du Coeur et des Vaisseaux 87(12): 1735-1738
1994
ISSN/ISBN: 0003-9683 PMID: 7786115 Document Number: 429849
Permanent pacemaker electrode infection is rare but can be fatal. The authors report two cases presenting with spondylodiscitis, a previously described mode of presentation of valve endocarditis but not previously reported in this context. In one case, recurrent courses of antibiotics did not prevent repeated episodes of bacteraemia. In the second, the relapse of infection occurred at different sites of the vertebral column until surgical removal of the electrodes: the usual features of this pathology were observed: frequent but not constant infection at the site of the pacemaker implantation, making the diagnosis more difficult; delayed signs of spondylodiscitis after implantation of the pacemaker; recurrence of infection when antibiotic therapy alone was prescribed and, therefore, the need for surgical ablation of all implanted material. The authors underline the diagnostic value of transoesophageal echocardiography.