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World J Cardiol. Jul 26, 2012; 4(7): 231-233
Published online Jul 26, 2012. doi: 10.4330/wjc.v4.i7.231
Published online Jul 26, 2012. doi: 10.4330/wjc.v4.i7.231
Implantable cardioverter defibrillator lead-related methicillin resistant Staphylococcus aureus endocarditis: Importance of heightened awareness
Obiora F Anusionwu, Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, United States
Cheri Smith, Harold E Harrison Medical Library, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, United States
Alan Cheng, Section of Cardiac Electrophysiology, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
Author contributions: Anusionwu OF designed the study and wrote the manuscript; Smith C critically reviewed and formatted the manuscript with assistance in literature review of evidence-based medical care; and Cheng A performed the lead extraction and helped to critically review the manuscript.
Correspondence to: Obiora F Anusionwu, MD, Clinical Instructor of Medicine, Division of Hospital Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL, West, 6th Floor, Baltimore, MD 21224, United States. bixon64us@yahoo.com
Telephone: +1-410-5505018 Fax: +1-410-5502972
Received: March 26, 2012
Revised: June 4, 2012
Accepted: June 11, 2012
Published online: July 26, 2012
Revised: June 4, 2012
Accepted: June 11, 2012
Published online: July 26, 2012
Abstract
Methicillin resistant Staphylococcus aureus (MRSA) septicemia is associated with high morbidity and mortality especially in patients with immunosuppression, diabetes, renal disease and endocarditis. There has been an increase in implantation of cardiac implantable electronic devices (CIED) with more cases of device-lead associated endocarditis been seen. A high index of suspicion is required to ensure patient outcomes are optimized. The excimer laser has been very efficient in helping to ensure successful lead extractions in patients with CIED infections. We present an unusual case report and literature review of MRSA septicemia from device-lead endocarditis and the importance of early recognition and prompt treatment.
Keywords: Endocarditis, Methicillin resistant Staphylococcus aureus, Sepsis, Pacemakers, Implantable cardioverter-defibrillator