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J Thorac Cardiovasc Surg 2005;130:937-938
© 2005 The American Association for Thoracic Surgery

Brief Communication

Unusual chronic pacemaker infection by Mycobacterium tuberculosis in a pediatric patient

Thomas Hellwig, MD a , Phalla Ou, MD a , * , Catherine Offredo, MD b , Dorothée Stephany, MD c , Damien Bonnet, MD, PhD a , Daniel Sidi, MD, PhD a

a Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France
b Laboratoire de Bactériologie-Virologie-Parasitologie, Hôpital Necker-Enfants Malades, Paris, France
c Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Paris, France

Received for publication April 4, 2004; accepted for publication April 21, 2004.

* Address for reprints: Phalla Ou, MD, Service de Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, 149 rue de Sèvres 75743, Paris Cedex 15, France (Email: phalla.ou@nck.ap-hop-paris.fr).

The first 20% of the full text of this article appears below.

Pacemaker infection with Mycobacterium tuberculosis has not been reported previously. We describe a case of pacemaker infection with M tuberculosis in an 8-year-old patient in a country in which tuberculosis is not endemic.

Clinical Summary

An 8-year-old patient had been followed up at our institution for a congenital cardiac malformation with a single-ventricle physiology. After multiple cardiac surgical interventions, an epicardiac pacemaker was implanted during cavopulmonary arterial anastomosis surgery for a complete atrioventricular block when the patient was 6 years old.

After a symptom-free interval of 11 months, the patient was seen with a subcutaneous abscess of the pacemaker site. The pacemaker was surgically removed, although only three of the four leads could be removed because one had integrated entirely into the myocardium. Bacteriologic cultures of the surgically removed material remained sterile. After 5 weeks of probabilistic intravenous antibiotic therapy, . . . [Full Text of this Article]






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