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Case Reports
. 2018 Mar 5:2018:9128560.
doi: 10.1155/2018/9128560. eCollection 2018.

A Case of Pacemaker Endocarditis Caused by Aerococcus urinae

Sandra Samuelsson  1 , Charles Kennergren  2 , Magnus Rasmussen  3   4
Affiliations
Case Reports

A Case of Pacemaker Endocarditis Caused by Aerococcus urinae

Sandra Samuelsson et al. Case Rep Infect Dis. .

Abstract

Background: Aerococcus urinae has lately been acknowledged as a cause of infective endocarditis (IE) especially in older males with underlying urinary tract disorders. In this population, cardiac implanted electronical devices (CIED) are not uncommon, but despite the capacity of A. urinae to form biofilm in vitro, no cases of aerococcal CIED infections have been reported to date.

Case presentation: An 84-year-old male with pacemaker was admitted with dysuria one month after a transurethral procedure for urinary bladder cancer. A. urinae was isolated from urine and blood. Transesophageal echocardiography (TEE) was without signs of vegetation on valves or pacing cables. The patient was treated with a twelve-day course of β-lactam antibiotics. Forty days after the initial admission, the patient was readmitted due to malaise, general pain of the joints, chills, and renewed blood cultures grew A. urinae. TEE demonstrated a 10 × 5 mm vegetation on either the tricuspid valve or one of the pacing cables. The pacemaker system was completely removed and demonstrated macroscopic signs of infection. A temporary system was implanted, and after 14 days of penicillin G treatment, a new system permanent system was implanted. Total treatment time was 40 days. Recovery was uneventful.

Conclusion: This report demonstrates that A. urinae can cause CIED infection. In patients with A. urinae bacteremia and a CIED, this risk must be considered, especially if bacteremia reoccurs.

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Figures

Figure 1
Figure 1
TEE demonstrating the lead (long arrow) and the vegetation (short arrow) attached to the lead.
See this image and copyright information in PMC

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References

    1. Aguirre M., Collins M. D. Phylogenetic analysis of some Aerococcus-like organisms from urinary tract infections: description of Aerococcus urinae sp. nov. Journal of General Microbiology. 1992;138(2):401–405. doi: 10.1099/00221287-138-2-401. - DOI - PubMed
    1. Christensen J. J., Korner B., Kjaergaard H. Aerococcus-like organism–an unnoticed urinary tract pathogen. APMIS. 1989;97(1–6):539–546. doi: 10.1111/j.1699-0463.1989.tb00828.x. - DOI - PubMed
    1. Christensen J. J., Jensen I. P., Faerk J., Kristensen B., Skov R., Korner B. Bacteremia/septicemia due to Aerococcus-like organisms: report of seventeen cases: Danish ALO Study Group. Clinical Infectious Diseases. 1995;21(4):943–947. doi: 10.1093/clinids/21.4.943. - DOI - PubMed
    1. Senneby E., Petersson A. C., Rasmussen M. Epidemiology and antibiotic susceptibility of aerococci in urinary cultures. Diagnostic Microbiology and Infectious Disease. 2015;81(2):149–151. doi: 10.1016/j.diagmicrobio.2014.11.009. - DOI - PubMed
    1. Senneby E., Göransson L., Weiber S., Rasmussen M. A population-based study of aerococcal bacteraemia in the MALDI-TOF MS-era. European Journal of Clinical Microbiology and Infectious Diseases. 2016;35(5):755–762. doi: 10.1007/s10096-016-2594-z. - DOI - PubMed

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