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Aspergillus infection of implantable cardioverter-defibrillators and pacemakers: case report and literature review

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Abstract

Presented here is a case of implantable-cardioverter-defibrillator infection caused by Aspergillus flavus and a review of 14 previously reported Aspergillus infections of pacemakers or implantable cardioverter-defibrillators. Among all 15 cases, fever was the most common presenting feature (11 patients). Three patients presented with generator-pocket inflammation. Transthoracic echocardiography was performed on eight of 13 patients with endocarditis, revealing vegetations in only one. Transesophageal echocardiography demonstrated the presence of vegetations in all eight of the patients on whom it was performed (p < 0.01). Death was due to the Aspergillus infection in five cases. Patients who presented with unexplained fever had a higher mortality rate (60%) than patients with other clinical presentations (20%, p = 0.166).

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References

  1. Pavia S, Wilkoff B (2001) The management of surgical complications of pacemaker and implantable cardioverter-defibrillators. Curr Opin Cardiol 16:66–71

    Article  PubMed  CAS  Google Scholar 

  2. Baddour LM, Bettmann MA, Bolger AF, Epstein AE, Ferrieri P, Gerber MA, Gewitz MH, Jacobs AK, Levison ME, Newburger JW, Pallasch TJ, Wilson WR, Baltimore RS, Falace DA, Shulman ST, Tani LY, Taubert KA (2003) Nonvalvular cardiovascular device-related infections. Circulation 108:2015–2031

    Article  PubMed  Google Scholar 

  3. Cook RJ, Orszulak TA, Nkomo VT, Shuford JA, Edwards WD, Ryu JH (2004) Aspergillus infection of implantable cardioverter-defibrillator. Mayo Clin Proc 79:549–552

    Article  PubMed  Google Scholar 

  4. Choo MH, Holmes DR Jr, Gersh BJ, Maloney JD, Merideth J, Pluth JR, Trusty J (1981) Permanent pacemaker infections: characterization and management. Am J Cardiol 48:559–564

    Article  PubMed  CAS  Google Scholar 

  5. Marchena PJ, Rodriguez JA, Garcia GA, Sanchis DV, Munos NS, Nunez JF (2006) Pacemaker lead infection caused by Aspergillus fumigatus. Eur J Intern Med 17:209–210

    Article  Google Scholar 

  6. Mateos-Colino A, Golpe R, Gonzalez-Rodriguez A, Gonzalez-Juanatey C, Legarra JJ, Blanco M (2005) Aspergillus pacemaker endocarditis presenting as pulmonary embolism. Respirology 10:396–398

    Article  PubMed  CAS  Google Scholar 

  7. Leong R, Gannon BR, Childs TJ, Isotalo PA, Abdollah H (2006) Aspergillus fumigatus pacemaker lead endocarditis: a case report and review of the literature. Can J Cardiol 22:337–340

    PubMed  CAS  Google Scholar 

  8. Cuesta JM, Farinas MC, Rodilla IG, Salesa R, de Berrazueta JR (2005) Aspergillus fumigatus endocarditis in a patient with a biventricular pacemaker. Rev Esp Cardiol 58:596–597

    Article  PubMed  Google Scholar 

  9. Kim HY, Kim CJ, Rho TH, Youn HJ, Cho EJ, Jin SW, Jeon HK, Chae JS, Kim JH, Hong SJ, Choi KB (2002) Aspergillus infection in a large thrombus of a permanent ventricular pacing lead. J Korean Med Sci 17:691–694

    PubMed  Google Scholar 

  10. Chambers J, Blauth C, Bucknall C, Eykyn S (2002) Images in clinical medicine. Aspergilloma as a complication of pacemaker implantation. N Engl J Med 346:428

    Article  PubMed  Google Scholar 

  11. Izquierdo R, Llorente C, Mayo J, Garcia-Porrua C, Gonzalez-Juanatey C, Gonzalez-Gay MA (2005) Pacemaker infection due to Aspergillus: report of two cases and literature review. Clin Cardiol 28:36–38

    PubMed  Google Scholar 

  12. Cacoub P, Leprince P, Nataf P, Hausfater P, Dorent R, Wechsle B, Bors V, Pavie A, Piette JC, Gandjbakhch I (1998) Pacemaker infective endocarditis. Am J Cardiol 82:480–484

    Article  PubMed  CAS  Google Scholar 

  13. Dunn CJ, Ruder M, Deresinski SC (1996) Aspergillus fumigatus infection of an automatic internal cardiac defibrillator. Pacing Clin Electrophysiol 19:2156–2157

    Article  PubMed  CAS  Google Scholar 

  14. Acquati F, Semeraro F, Respighi E, Gallotti R, Repetto S, Binaghi G (1987) Aspergillus flavus infection of a pacemaker wire: continuing evidence for active management of infected pacemakers. It J Practice Cardiol 17:467–468

    CAS  Google Scholar 

  15. Kramer L, Rojas-Corona RR, Sheff D, Eisenberg ES (1985) Disseminated aspergillosis and pacemaker endocarditis. Pacing Clin Electrophysiol 8:225–229

    Article  PubMed  CAS  Google Scholar 

  16. Moorman JR, Steenbergen C, Durack DT (1984) Aspergillus infection of a permanent ventricular pacing lead. Pacing Clin Electrophysiol 7:361–366

    Article  PubMed  CAS  Google Scholar 

  17. Ellis ME, Al-Abdely H, Sandridge A, Greer W, Ventura W (2001) Fungal endocarditis: evidence in the world literature, 1965–1995. Clin Infect Dis 32:50–62

    Article  PubMed  CAS  Google Scholar 

  18. Bohm A, Banyai F, Preda I, Zamolyi K (1996) The treatment of septicemia in pacemaker patients. Pacing Clin Electrophysiol 19:1105–1111

    Article  PubMed  CAS  Google Scholar 

  19. Hawser SP, Douglas LJ (1994) Biofilm formation by Candida species on the surface of catheter materials in vitro. Infect Immun 62:915–921

    PubMed  CAS  Google Scholar 

  20. Herbrecht R, Denning DW, Patterson TE, Bennett JE, Greene RE, Oestmann JW, Kern WV, Marr KA, Ribaud P, Lortholary O, Sylvester R, Rubin RH, Wingard JR, Stark P, Durand C, Caillot D, Thiel E, Chandrasekar PH, Hodges MR, Schlamm HT, Troke PF, de Pauw B (2002) Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 347:408–415

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The authors wish to thank M. Hadley-Adams for assisting with the English-language revision and preparation of the manuscript.

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Authors and Affiliations

  1. Department of Cardiology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, San Martin de Porres no. 4, 28050, Madrid, Spain

    M. Cobo, J. Toquero & I. Fernández

  2. Department of Internal Medicine, Infectious Diseases Unit, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, San Martin de Porres no. 4, 28050, Madrid, Spain

    A. Ramos & E. Muñez

  3. Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, San Martin de Porres no. 4, 28050, Madrid, Spain

    T. Alvárez-Espejo

  4. Department of Microbiology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, San Martin de Porres no. 4, 28050, Madrid, Spain

    M. Muñoz

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  1. M. Cobo
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  2. A. Ramos
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  3. J. Toquero
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  4. E. Muñez
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  5. T. Alvárez-Espejo
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  6. M. Muñoz
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  7. I. Fernández
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Corresponding author

Correspondence to A. Ramos.

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Cobo, M., Ramos, A., Toquero, J. et al. Aspergillus infection of implantable cardioverter-defibrillators and pacemakers: case report and literature review. Eur J Clin Microbiol Infect Dis 26, 357–361 (2007). https://doi.org/10.1007/s10096-007-0292-6

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  • DOI: https://doi.org/10.1007/s10096-007-0292-6

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