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Staphylococcus simulans bloodstream infection following CIED extraction
  1. John Raymond Go1,
  2. Cristina Corsini Campioli1,
  3. Daniel DeSimone1 and
  4. Muhammad Rizwan Sohail1,2
  1. 1Division of Infectious Disease, Mayo Clinic Minnesota, Rochester, Minnesota, USA
  2. 2Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Muhammad Rizwan Sohail; sohailmd{at}


A 78-year-old man with an implantable cardioverter-defibrillator (ICD) presented with chills and malaise. His history was significant for heart failure with reduced ejection fraction and complete heart block. He had undergone permanent pacemaker placement that was later upgraded to an ICD 5 years before his presentation. Physical examination revealed an open wound with surrounding erythema overlying the device site. Blood cultures obtained on admission were negative. Transesophageal echocardiogram did not show valve or lead vegetations. He underwent a prolonged extraction procedure. Postoperatively, he developed septic shock and cultures from the device, and repeat peripheral blood cultures grew Staphylococcus simulans and Staphylococcus epidermidis. He was treated with intravenous vancomycin but had refractory hypotension, leading to multiorgan failure. He later expired after being transitioned to comfort care. The patient may have acquired S. simulans by feeding cows on a nearby farm, and the prolonged extraction procedure may have precipitated the bacteraemia.

  • interventional cardiology
  • infections
  • wound care

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  • Contributors JRG, CCC, DD and MRS contributed to the conceptualisation, planning, visualisation and writing/reporting of this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.