RESUMEN
A 73-year-old man was admitted for intermittent episodes of fever and chills for 3 months. He had been implanted with a permanent pacemaker to control tachy-bradycardia syndrome 7 months before admission. Blood cultures were positive for Actinobacillus actinomycetemcomitans and a 99mTc-hexamethylpropylene amine oxime (99mTc-HMPAO) WBC scan revealed inflammation on the pacemaker lead in extracardiac site. Oral examination revealed several dental caries. The patient was treated with intravenous ceftriaxone, followed by oral ciprofloxacin without removal of the infected pacemaker lead. He was doing well 10 months without febrile episodes after discontinuation of antibiotics. This report describes the first case of A. actinomycetemcomitans bacteremia associated with a pacemaker lead and localized by 99mTc-HMPAO WBC scan
Asunto(s)
Anciano , Humanos , Actinobacillus , Aggregatibacter actinomycetemcomitans , Antibacterianos , Bacteriemia , Ceftriaxona , Escalofríos , Ciprofloxacina , Caries Dental , Diagnóstico Bucal , Fiebre , Inflamación , Exametazima de Tecnecio Tc 99mRESUMEN
A 73-year-old man was admitted for intermittent episodes of fever and chills for 3 months. He had been implanted with a permanent pacemaker to control tachy-bradycardia syndrome 7 months before admission. Blood cultures were positive for Actinobacillus actinomycetemcomitans and a 99mTc-hexamethylpropylene amine oxime (99mTc-HMPAO) WBC scan revealed inflammation on the pacemaker lead in extracardiac site. Oral examination revealed several dental caries. The patient was treated with intravenous ceftriaxone, followed by oral ciprofloxacin without removal of the infected pacemaker lead. He was doing well 10 months without febrile episodes after discontinuation of antibiotics. This report describes the first case of A. actinomycetemcomitans bacteremia associated with a pacemaker lead and localized by 99mTc-HMPAO WBC scan