Elsevier, Journal of Cardiology Cases, 2(1), p. e92-e94, 2010
DOI: 10.1016/j.jccase.2009.09.003
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The patient was a 67-year-old male who received implantable cardioverter defibrillator (ICD) due to dilated cardiomyopathy and ventricular tachycardia 10 years previously. In September 2007, he was admitted to our hospital for dilated cardiomyopathy accompanied by congestive heart failure. Since he suffered from pneumonia and respiratory insufficiency, he was treated with steroid, long-term artificial respirator, and central venous catheter placement. Congestive heart failure and pneumonia improved; however, he was diagnosed as having ICD lead infection and infective endocarditis because of a positive blood culture for methichillin-resistant Staphylococcus aureus (MRSA). After 2 months of appropriate anti-MRSA agent administration, the ICD lead was surgically removed and his tricuspid valve was replaced. The postoperative course was uneventful; a cardiac resynchronization therapy defibrillator (CRT-D) was reimplanted 6 weeks after lead extraction. We experienced a case with long-term ICD lead infection and lead-related infective endocarditis in the tricuspid valve caused by MRSA in a patient with poor cardiac function, which is the first successful case in Japan.