ABSTRACT
A 58-year-old woman, had received a transvenous permanent pacemaker was the subject of this study. Cervical phlegmon, induced by gastroduodenoscopy infected the tract of the transvenous pacemaker lead inserted into the left subclavian vein by the puncture method. Local management was unsuccessful, and consequently, microbial endocarditis developed with tricuspid valve vegetation. Removal of the entire system under cardiopulmonary bypass successfully eliminated the infection. It is neccesary that pacemaker patients undergoing procedures that may be associated with infections receive prophylactic antibiotics before such procedures. Patients with pacemaker infections should undergo aggressive total removal of the pacemaker system at an early stage of infection, particularly in cases with bacteremia.