Case Age (yrs) Gender Illnesses Device type Length of device use before infection Symptoms Echo result Culture results Management/outcome Davis et al. 1969 71 Male Diabetes, obstructive uropathy, UTI, CHF Permanent pacemaker 9 months Fever, confusion, leukocytosis Not reported Blood: no growth; urine: yeast Broad-spectrum antibacterials. Patient expired. Cole et al. 1986 65 Male CVA, IV catheter-related Candida albicans fungemia 6 months prior Permanent pacemaker 8 years Fever, confusion, urine/fecal incontinence Initial blood and urine cultures: no growth. Subsequent blood culture: Candida albicans Broad-spectrum antibacterials followed by amphotericin B. Thoracotomy. Expired at surgery. Wilson et al. 1993 56 Male Heart block Permanent pacemaker 5 years Fever, cough, dyspnoea, leukocytosis Multiple large RA masses prolapse into RV. Possible adherence to pacer wire. (TTE) Blood: Candida albicans Amphotericin B (2 g total). Right atriotomy and pulmonary arteriotomy. Removed leads and fungus ball from left main PA. Recovered, well after 2 years Shmuely et al. 1997 75 Male Diabetes, sick sinus syndrome Permanent pacemaker 2 years Blurred vision, endophthalmitis 3 cm vegetation on pacer wire below TV, within RV (TEE) Blood: Candida tropicalis Amphotericin B+5-flucytosine. Refused surgery to remove PPM. Expired with multiorgan failure Joly et al. 1997 56 Male Chronic bronchitis, sinus dysfunction Permanent pacemaker 4 years: old PPM wires, 3 months: new PPM Fever, dyspnoea RA mass (TEE) Initial blood culture: no growth. Blood then positive for Candida albicans . Wires and vegetation: Candida albicans Right atriotomy: removed vegetation, wires, and PPM. Amphotericin B+5-flucytosine, then oral fluconazole × 7 months. Recovered Cacoub et al. 1998 56 Male Sick sinus syndrome Permanent pacemaker Not reported Fever, dyspnoea Vegetation on pacer lead Blood and pacer lead: S . epidermidis, Candida albicans Antibiotic. Surgical removal of PPM. Survived. Victor et al. 1999 72 Male Bradycardia, tachycardia syndrome Permanent pacemaker <1 month Not reported Vegetation on TV Lead culture: Candida glabrata Endovascular extraction of PPM. Expired after 2 months with active Candida endocarditis Kurup et al. 2000 77 Male Diabetes, coronary artery disease, sick sinus syndrome Permanent pacemaker 5 months Fever, dyspnoea, lethargy TV vegetation (TTE) Blood, vegetation: Candida tropicalis Amphotericin B. Thoracotomy: vegetation on TV and PPM lead. Removed PPM and vegetations. Expired with multiorgan failure after surgery. Roger et al. 2000 87 Male CML, renal neoplasm, prosthetic AV Permanent pacemaker 16 years Fever, renal insufficiency 7 cm vegetation on pacer wire (TTE+TEE) Blood, vegetation: Candida albicans and Candida glabrata Fluconazole. Not a surgical candidate. Expired with fatal stroke Brown et al. 2001 49 Male Diabetes, coronary artery disease, CHF, ventricular tachycardia Implanted cardioverter defibrillator 12 months Fever, dyspnoea, cough, leukocytosis 3.5 cm vegetation on defibrillator lead (TTE) Blood and vegetation: Candida albicans Amphotericin B × 8 weeks, then fluconazole 400 mg P.O. daily. Explanted device by thoracotomy. Clinically stable 6 months later Hindupur and Muslin 2005 63 Male Coronary artery disease, CHF, ventricular tachycardia Implanted cardioverter-defibrillator 10 months Fatigue Vegetations on atrial ICD lead (largest: 1.6 cm) (TTE+TEE) Blood, ICD lead and pocket: Candida albicans Removed generator, percutaneous extraction of ICD lead. Lead fractured, embolised with vegetation into left PA. Received fluconazole, then amphotericin B. improved, then expired with P. aeruginosabacteraemia Ho et al. 2006 56 Male Rheumatic heart disease, cardiomyopathy, ventricular tachycardia Implanted cardioverter-defibrillator 12 years; generator change 1 week before Fever, sweat, hypotension, ICD pocket dehisced 1.8 cm mobile vegetation on intracardiac lead (TEE) Blood: Candida parapsilosis Fluconazole IV × 6 weeks, then oral fluconazole 400 mg da: 1 lifelong. Explanted device. Survived Talarmin et al. 2009 76 Male Colorectal cancer Permanent pacemaker Not reported Not reported Not reported Blood: Candida parapsilosis Removed PPM: found vegetations on leads. Received fluconazole for 42 days. Expired secondary to abdominal surgery complications Falcone et al. 2009 38 Male Previous aortic valve replacement Permanent pacemaker 3 months Fever Vegetations on pacer lead Lead culture: Candida parapsilosis Removed PPM. Received caspofungin for 6 weeks, then 12 weeks oral fluconazole and posaconazole. Cured at 14 months follow-up Durante-Mangoni and Nappi 2010 19 Male Complete heart block Permanent pacemaker 1 year Fever, cough, hemoptysis Massive, mobile structure on pacer lead Blood: Candida albicans Caspofungin and fluconazole × 8 weeks, removal and replacement of ICD. Recovered. Halawa et al. 2011 80 Male Coronary artery disease, COPD, atrial fibrillation, complete heart block Permanent pacemaker 12 years Chills, confusion Blood and pacer vegetation: Candida parapsilosis Amphotericin B, maintained for 3 weeks after PPM removed. PPM explantation and percutaneous lead extraction, no infection at 1 year follow-up. Grunberg et al. 2013 62 Male CHF, diabetes, coronary artery disease, hepatitis C infection Implanted cardioverter-defibrillator 11 months Fever, dyspnea on exertion, chest pressure 4 cm mass on ICD lead Blood: Candida albicans Fluconazole IV, ICD removal. Plan 6 weeks of fluconazole before ICD reimplantation. Tascini et al. 2013 75 Female Symptomatic bradycardia Permanent pacemaker 6 years Fever × 2 weeks 2 cm vegetation adherent to the atrial lead of the bicameral PM Blood: Candida albicans IV fluconazole × 10 days, then IV micafungin × 75 days. Survived. Rivera et al. 2014 60 Female HF with reduced EF, sarcoidosis, and diabetes Implanted cardioverter defibrillator 2 years, 2 months Fevers, chills, sweats, cough Mobile Blood: Candida albicans Removed ICD. Micafungin × 2 weeks, then fluconazole × 6 weeks. Survived. Bandyopadhyay et al. 2015 86 Male Diabetes Permanent pacemaker 3 years Weakness, fever Vegetation on the pacemaker electrode in right atrium and ventricle Blood: Candida tropicalis IV caspofungin × 10 days, then IV fluconazole ×15 days, then oral fluconazole × 2 months. Survived. Glavis-Bloom et al. 2015 70 Female CHF, diabetes, chronic kidney disease Implanted cardioverter-defibrillator 13 months Fever, nausea, vomiting, fatigue Multiple ICD lead masses and 0.7 cm mobile aortic valve mass Blood and urine: Candida glabrata Caspofungin IV × 3 days, then micafungin IV and flucytosine IV. Expired with multiorgan failure 1 month later. Jain et al. 2018 60 Female Diabetes, ischemic cardiomyopathy, pancytopenia Implanted cardioverter-defibrillator Not reported Fever, altered mental status Mass attached to the tricuspid valve Blood: Candida parapsilosis Amphotericin B, removed ICD and leads, removed tricuspid valve vegetations. Survived. Jones et al. 2018 25 Female Obesity, hypertension, diabetes, nonischemic cardiomyopathy Implanted cardioverter-defibrillator 2 years, 9 months Not reported Large vegetation above the tricuspid valve, Blood: Candida albicans AngioVac aspiration and laser sheath extraction of ICD lead, suppressive fluconazole. Survived.
