Pacemakerinfection ,,81-years-oldPresentedwithrecurrentsyncopeHoltershowedsicksinussyndromeVVIimplantedinJuly2005,identandEmergencydepartment(AED),AttendedAEDinOct,plainedofpacerwoundpainandswellingTreatedascellulitiswithampicillinandcloxacillin3dayslater,attendedAEDagainforincreasingpacerwoundpainandswellingIncisionanddrainagewasdoneinAED!!Referredtogeneralclinicforwounddressing!!urseAdmittedtomedicalwardandcardiologistwastheninformedatthisjunctureOpenwoundwithpacerexposedAfebrileTreatedasinfectedpacingwoundwithexposureofthepacerboxEmergencyoperationarrangedandpacerwasremovedWoundswabsweretakenPocketwascleanedbyhydrogenperoxidePutonacourseofcefazolinAsthepatientremainedasymptomaticafterremovalofpacer,herefusedtohavepacemakerimplantationFollowedup,Noticedhavepainfulerythematouslesionwithscalingandpus-asionsHowever,granulomadevelopedoverthepacerwoundagainCauterizationbysilvernitratetriedbutfailedSurgeronwasconsultedforsurgicalremovalofgranulomatogetherwiththeunderlyingandsurroundingtissue(?duetotheirritationofthetissuebythepacingleadsorunderlyingchronicinfection)GranulomaregrewaftersurgeryEventually,patientwasreferredtoQueenElizabethHospitalforremovalofpacingleadbylasersheathduetosuspectedleadinfectionHowever,mon,occurringinapproximately~1-7%ofimplantedpacingsystemAmongstudyperiod,therewasa49%riseinnumberofnewdevicesimplantation(from159,585in1996to237,720in2003)160%forICDsand31%-fold(-foldforPMs,6-foldforICDs)RisingRatesofCardiacRhythmManagementDeviceInfectionsintheUnitesStates:1996through2003AndrewViogt,AlaaShalaby,;48;590-591
心脏起搏器感染病 来自淘豆网m.daumloan.com转载请标明出处.
