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Case Reports: Rare disease
Pacemaker lead-related endocarditis with Neisseria sicca
  1. Margaret Locke1,
  2. Alexander Smith1,
  3. Laurence M Epstein2,
  4. Negin Niknam3 and
  5. Rubina Boparai4
  1. 1Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
  2. 2Department of Cardiology, Northwell Health, Manhasset, New York, USA
  3. 3Department of Infectious Diseases, Northwell Health, Manhasset, New York, USA
  4. 4Department of Internal Medicine, North Shore University Hospital, Manhasset, New York, USA
  1. Correspondence to Dr Margaret Locke; maggielwo{at}yahoo.com

Abstract

We report the first known case of Neisseria sicca-associated pacemaker lead endocarditis—a disease whose incidence and mortality are growing. A woman in her 70s with a history of transcatheter aortic valve replacement and pacemaker placement 7 months earlier presented with recurrent fevers. She visited the emergency department several times during the past 2 months for these fevers, and she had been given oral antibiotics for presumed urinary tract infections. Investigations revealed blood cultures growing N. sicca. Although transthoracic echocardiogram was negative, transesophageal echocardiogram showed two vegetations on the right atrial lead which suggested pacemaker lead-associated endocarditis. A complete pacemaker and lead extraction was performed, and the patient recovered completely and was discharged home to complete 6 weeks of intravenous ceftriaxone with plans for follow-up echocardiography. We hope that this case will contribute to the growing body of literature regarding device infections, thus leading to earlier identification and treatment.

  • Infections
  • Pacing and electrophysiology
  • Infectious diseases
  • Cardiovascular medicine

https://doi.org/10.1136/bcr-2022-249795

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    Footnotes

    • Contributors ML was the lead author for this case report. ML, AS and RB were the primary team in charge of patient care. LE and NN were consultants on the case. All authors contributed to the writing and editing of the manuscript.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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