Native Valve Endocarditis and Pacemaker Infection with Mycobacterium Fortuitum: A Descriptive Approach

Abstract

We describe a case of native tricuspid valve endocarditis and pacemaker infection secondary to M. fortuitum. We also review the published literature on cardiac device–associated infections and native valve endocarditis caused by M. fortuitum. Endocarditis and cardiac device infection due to Mycobacterium fortuitum is a rare entities in hospital settings. Most endocarditis has an infectious cause of bacterial origin. Being a disease of the endocardium, it not only affects native structures -more frequently the valves or cardiac structures subjected to special hemodynamic conditions such as in congenital heart disease-, but also other endothelizable surfaces, such as valve prostheses, catheters, electrodes, or percutaneous devices. Two days after admission, with fever, chills, body aches, and swelling around her pacemaker, the patient’s pacing system was surgically removed. The patient was discharged on day 16 after surgery and treated with a multidrug regimen of azithromycin, levofloxacin, imipenem/ cilastatin, and amikacin for six weeks, followed by trimethoprim/ sulfamethoxazole plus doxycycline for a further three months.