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Giant endocarditis vegetation on a pace-maker lead
- 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.
- Subjects :
- Male
medicine.medical_specialty
Pacemaker, Artificial
Heart block
Polymorphism, Single Nucleotide
law.invention
chemistry.chemical_compound
Young Adult
law
medicine.artery
Sepsis
Internal Medicine
medicine
Endocarditis
Humans
Thrombophilia
Methylenetetrahydrofolate Reductase (NADPH2)
business.industry
Candidiasis
Endocarditis, Bacterial
medicine.disease
Intensive care unit
Pulmonary hypertension
Surgery
chemistry
Pulmonary artery
Emergency Medicine
Implant
Caspofungin
business
Abdominal surgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....303c37f8288e4ec2960e1b997d237601