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Giant endocarditis vegetation on a pace-maker lead

Authors :
Emanuele Durante-Mangoni
Gianantonio Nappi
DURANTE MANGONI, Emanuele
Nappi, Gianantonio
Publication Year :
2010

Abstract

A 19 year-old man presented with a 2-month history of fever, cough and hemoptysis that were unresponsive to broad spectrum antibiotics. He had been implanted with an epicardial pace-maker at the age of 5 for complete heart block. One year before presentation, he experienced rupture of the epicardial implant following a car accident, and underwent emergency placement of an endocardial pacemaker. He also underwent orthopedic and abdominal surgery for multiple bone fractures and mesenteric artery aneurysm, with a resultant long-lasting intensive care unit stay. On admission to our hospital, computed tomography of the chest showed bilateral pulmonary inflammatory infiltrates with multiple pulmonary artery emboli. Trans-thoracic echocardiography showed a massive, mobile structure adhering to the pace-maker lead and severe pulmonary hypertension. Multiple blood cultures grew Candida albicans. The patient remained highly febrile and septic despite full dose combination antifungal treatment with caspofungin and fluconazole.

Details

Language :
English
Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....303c37f8288e4ec2960e1b997d237601