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BMJ Case Reports 2009; doi:10.1136/bcr.05.2009.1910
  • Reminder of important clinical lesson

Management of recurrent pacemaker-related bacteraemia with small colony variant Staphylococcus aureus in a haemodialysis patient

  1. Xiaohui Chen Nielsen1,
  2. Finn Thomsen Nielsen2,
  3. Jørgen A L Kurtzhals3,
  4. Claus Moser3,
  5. Kit Boye4,
  6. Jens Jørgen Christensen5,
  7. Ulla Rydal Johansen3,
  8. Henrik Westh4
  1. 1
    Næstved Sygehus, Clinical Microbiology, Herlufvænge 14A, Næstved, 4700, Denmark
  2. 2
    Rigshospitalet, Copenhagen University Hospital, Department of Nephrology, Blegdamsvej 9, Copenhagen, 2100, Denmark
  3. 3
    Rigshospitalet, Copenhagen University Hospital, Department of Clinical Microbiology, Blegdamsvej 9, Copenhagen, 2100, Denmark
  4. 4
    Hvidovre Hospitalet, Department of Clinical Microbiology, Kettegård alle 30, Copenhagen, 2650, Denmark
  5. 5
    Statens Serum Institut, Department of Bacteriology, Mycology and Parasitology, Artillerivej 5, Copenhagen, 2300, Denmark
  1. Xiaohui Chen Nielsen, xcn{at}regionsjaelland.dk
  • Published 20 August 2009

Summary

A patient with chronic haemodialysis with a cardiac pacemaker was admitted for five episodes of bacteraemia with Staphylococcus during an 8-month period. The species identification was complicated since the morphological characters and biochemical reactions were unusual and differing. Molecular biological identification and typing methods revealed that the pathogens for all the episodes were the same strain of Staphylococcus aureus that had small colony variant characteristics. Continuous suppressive antibiotic treatment initiated after the last infection episode has been able to keep the patient free of bacteraemia relapse during the past 24 months without removing the pacemaker.

Footnotes

  • Competing interests: none.

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

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