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Case Reports
. 2021 May 27;14(5):e240309.
doi: 10.1136/bcr-2020-240309.

Staphylococcus simulans bloodstream infection following CIED extraction

John Raymond Go  1 , Cristina Corsini Campioli  1 , Daniel DeSimone  1 , Muhammad Rizwan Sohail  2   3
Affiliations
Case Reports

Staphylococcus simulans bloodstream infection following CIED extraction

John Raymond Go et al. BMJ Case Rep. .

Abstract

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.

Keywords: infections; interventional cardiology; wound care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Left chest pocket showing erosion of the generator through the skin along with surrounding erythema and serous drainage.
Figure 2
Figure 2
Chest roentgenogram (anterior) showing the pocket generator and transvenous cardiovascular implantable electronic device leads including abandoned leads.
Figure 3
Figure 3
Chest roentgenogram (lateral) showing the pocket generator and transvenous cardiovascular implantable electronic device leads including abandoned leads.
See this image and copyright information in PMC

References

    1. Dai M, Cai C, Vaibhav V, et al. Trends of Cardiovascular Implantable Electronic Device Infection in 3 Decades: A Population-Based Study. JACC Clin Electrophysiol 2019;5:1071–80. 10.1016/j.jacep.2019.06.016 - DOI - PubMed
    1. Sohail MR, Uslan DZ, Khan AH, et al. Management and outcome of permanent pacemaker and implantable cardioverter-defibrillator infections. J Am Coll Cardiol 2007;49:1851–9. 10.1016/j.jacc.2007.01.072 - DOI - PubMed
    1. Greenspon AJ, Patel JD, Lau E, et al. 16-year trends in the infection burden for pacemakers and implantable cardioverter-defibrillators in the United States 1993 to 2008. J Am Coll Cardiol 2011;58:1001–6. 10.1016/j.jacc.2011.04.033 - DOI - PubMed
    1. DeSimone DC, Sohail MR, Mulpuru SK. Contemporary management of cardiac implantable electronic device infection. Heart 2019;105:heartjnl-2017-312146. 10.1136/heartjnl-2017-312146 - DOI - PubMed
    1. Le KY, Sohail MR, Friedman PA, et al. Impact of timing of device removal on mortality in patients with cardiovascular implantable electronic device infections. Heart Rhythm 2011;8:1678–85. 10.1016/j.hrthm.2011.05.015 - DOI - PubMed

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Supplementary concepts