CLOSED CAPSULE GENTAMICIN LAVAGE AS A SUCCESSFUL UNUSUAL THERAPY FOR PACEMAKER POCKET ABSCESS: A CASE REPORT

Abstract

Abstract

Introduction: Standard treatment for pacemaker pocket abscess is a surgical complete pacemaker system explantation and prolonged systemic antibiotic therapy. This is expensive and not always feasible. The aim of this study was to describe a new alternative treatment method for pacemaker pocket abscess. 

Case presentation: We present an 80-year-old woman with a history of heart failure, now with a staphylococcus aureus positive pacemaker pocket abscess. Referral to surgery for pacemaker explantation was not directly possible, due to the physical and mental state of the patient. Systemic gentamicin therapy was impossible, as a result of renal failure. A minimally invasive lavage treatment was thus performed. The pacemaker pocket abscess was punctured whilst maintaining the structural integrity of the abscess wall. After a closed lavage regimen of four weeks, there was no sign of recurrence of the infection. After one year follow-up, the patient is free of local or systemic infections. To our knowledge, this is the first report of this method of minimally invasive percutaneous closed abscess lavage. 

Conclusion: Gentamicin lavage of a pacemaker pocket abscess may be a feasible treatment option if a surgical pacemaker system explantation is not possible.