Endocarditis associated with the use of a transvenous pacemaker electrode remains an infrequent occurrence in spite of the increasing numbers of such pacemakers being utilized. However, when it does occur, endocarditis in such a setting poses a serious therapeutic dilemma. Eradication of infection is extremely difficult without removal of the foreign body, but since transvenous pacemakers usually become fixed to the endocardial surface with passage of time, their removal may require major intracardiac surgery. This report illustrates endocarditis in a patient with two transvenous pacemaker electrodes, in whom an apparent cure has been obtained with the use of combined antibiotic therapy without removal of either electrode.
A 59-year-old man was admitted to the Albuquerque Veterans Administration Hospital in November 1973, with complaints of shaking chills and temperature elevation of eight weeks' duration. These febrile episodes occurred sporadically and infrequently until two weeks prior to admission, at which