A case report of pacemaker endocarditis presenting as osteitis in a high-surgical-risk patient: a management challenge with thromboaspiration and leadless pacemaker implantation

Description

Beladel and colleagues describe a heart-device infection that announced itself in a heel. Their 2026 case report concerns an 83-year-old man who came in with fever and a painful heel. He then developed heart failure symptoms. Blood cultures grew Staphylococcus aureus. Imaging found bone infection in the heel and spinal disc infection. It also found a 26-millimetre vegetation riding on his pacemaker lead at the tricuspid valve. A lung embolism complicated the picture.

Surgery was judged too risky. A multidisciplinary team chose a percutaneous route instead. The vegetation was sucked out by thromboaspiration and the whole device extracted. A temporary-permanent externalised system kept his heart paced. Once the infection cleared, a leadless pacemaker was implanted inside the heart. He recovered without recurrence on follow-up. The authors highlight leadless devices and aspiration as strategies that cut reinfection and embolism risk in frail patients.

Catalog record

Source: https://europepmc.org/article/MED/PMC13472168