Septic Pulmonary Embolism Caused by Infected Pacemaker Leads After Replacement of a Cardiac Resynchronization Therapy Device

Comparison of the Clinico-Microbiological Characteristics of Culture-Positive and Culture-Negative Septic Pulmonary Embolism: A 10-Year Retrospective Study

Septic pulmonary embolism (SPE) is a rare yet serious infectious disorder with nonspecific clinical findings due to microorganism-containing emboli disseminating from extrapulmonary infectious foci. It is unknown whether a positive blood culture correlates with a worse clinical outcome. We compared the clinical and microbiologic characteristics of patients with SPE divided into the culture-positive group and the culture-negative one. This study was a retrospective observational study of the patients diagnosed with SPE and treated in an academic hospital from April 2010 to May 2020. We identified six culture-positive and four culture-negative patients with SPE during the study period. The culture-positive group had significantly longer periods of hospitalization (median: 75 days, range: 45-125 days) than the culture-negative group (median: 14.5 days, range: 3-43 days) (p < 0.05), as well as significantly elevated serum C-reactive protein and procalcitonin. Patients with culture-negative SPE more commonly had odontogenic infections as the primary infectious foci. Our study highlights the importance of giving extra attention to SPE patients who have a positive blood culture, as they may have worse clinical outcomes. Physicians need to collaborate with dentists when faced with patients with culture-negative SPE, since they may have primary odontogenic infections.

Delayed Pacemaker Generator Pocket and Lead Primary Infection Due to Burkholderia Cepacia

BACKGROUND Recently, the use of cardiac implantable electrophysiological devices (CIEDs) has increased. Advances in medical technology, an increasingly aging population, increases in clinical indications, and expanded medical insurance coverage for these devices have all contributed to this trend. Infection is considered to be one of the most serious complications of CIEDs and carries a significant risk of morbidity and mortality. Although infection with Staphylococcus sp. accounts for the majority of cases, other bacteria have been implicated as causative agents of infection of CIEDs. CASE REPORT We report the first case of primary pacemaker generator pocket and lead infection due to Burkholderia cepacia (B. cepacia) in the state of Qatar. To our knowledge, there have been few cases of CIED infection due to B. cepacia previously reported in the literature. CONCLUSIONS This case raises awareness of B. cepacia as a potential opportunistic pathogen in CIED infection. The more rare bacteria require culture on special media to provide an early diagnosis to enable proper antimicrobial therapy to commence. Adherence to infection control standards during CIED insertion would reduce infection from B. cepacia.