BMJ Case Reports 2009; doi:10.1136/bcr.02.2009.1608
  • Rare disease

Pacemaker endocarditis: an important clinical entity

  1. Kalpa De Silva1,
  2. Amanda Fife2,
  3. Francis Murgatroyd3,
  4. Nicholas Gall3
  1. 1
    St Thomas’ Hospital, Department of Cardiology, Westminster Bridge Road, London SE1 7EH, UK
  2. 2
    King’s College Hospital, Microbiology Department, Denmark Hill, London SE5 9RS, UK
  3. 3
    King’s College Hospital, Department of Cardiology, Denmark Hill, London SE5 9RS, UK
  1. Kalpa De Silva, kalpa.de_silva{at}
  • Published 18 November 2009


Pacemaker endocarditis remains a rare but potentially life threatening complication of pacemaker implantation. This case illustrates a rare cause of pacemaker endocarditis, Serratia marcescens, the management difficulties that can be faced with such organisms, and the potential indolent nature of pacemaker lead associated endocarditis. A review of the current data for pacemaker endocarditis management suggests that treatment with antimicrobials alone is unlikely to be curative and explantation of the device is recommended in all cases of confirmed pacemaker endocarditis (by echocardiography, in correlation with the patient’s clinical condition and inflammatory markers).


  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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