Work

FDG PET/CT–Guided Extraction of Infected Implantable Cardioverter-Defibrillator Causing Recurrent Stenotrophomonas Maltophilia Bacteremia

Year: 2025

Type: article

Abstract: BACKGROUND: Gram-negative bacteremia rarely cause cardiac implantable electronic device infections (CIEDIs), thus challenging prompt diagnosis and device extraction. CASE SUMMARY: F-FDG PET/CT) demonstrated ICD seeding. The device was extracted, and the patient was treated with trimethoprim-sulfamethoxazole and levofloxacin, with bacteremia resolution. Results of intraoperative cultures confirmed device infection with S. maltophilia, a multidrug-resistant, biofilm-forming, gram-negative pathogen. The ICD was later reimplanted subcutaneously to lower the infection risk. DISCUSSION: F-FDG PET/CT can guide CIEDI diagnosis when a patient has occult bacteremia and uncertain device seeding. TAKE-HOME MESSAGE: Maintain suspicion for cardiac device involvement in S. maltophilia bacteremia and use FDG PET CT when CIEDI is unclear.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.103405