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Fungal infection of implantable cardioverter-defibrillators: case series of five patients managed over 22 years.

Abstract：

BACKGROUND:With the increasing use of implantable cardioverter-defibrillators (ICDs), device complications are becoming more common. Fungal-related ICD infections have rarely been reported, and little is known about the presentation, prevalence, and treatment options for these morbid infections. OBJECTIVES:The purpose of this study was to characterize the clinical features, treatment, and outcomes of patients with fungal ICD infections. METHODS:We performed a retrospective review of ICD procedures performed at a single academic center and identified all ICD-related infections managed between 1983 and 2005. RESULTS:Among a total of 3,648 ICD-related procedures performed between 1983 and 2005, we identified 47 (1.3%) cases of ICD infections, of which 5 (0.1%) were due to a fungal pathogen. Fungal infections were more likely to be associated with abdominal devices, to have a local rather than systemic infection, and to have a longer duration from the original implant to presentation. All patients were treated with ICD system explantation and antifungal therapy. CONCLUSION:Fungal infection of ICDs is a rare but serious complication of device implantation that must be treated aggressively with complete hardware explantation and prolonged antifungal therapy. Because most infections are late complications and have indolent onsets, a high level of clinical suspicion is required for early diagnosis.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Ho IC,Milan DJ,Mansour MC,Mela T,Guy ML,Ruskin JN,Ellinor PT

doi

10.1016/j.hrthm.2006.04.012

subject

Has Abstract

pub_date

2006-08-01 00:00:00

pages

919-23

issue

8

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(06)01369-5

journal_volume

3

pub_type

杂志文章

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