A rare cause of pacemaker related endocarditis

We report the case of a 76-year-old man who had a dual-chamber pacemaker implanted 17 years before and was initially admitted due to a Campylobacter fetus bacteraemia without any evident source of infection. He was treated by imipenem/cilastatin followed by ciprofloxacin for a total of four weeks. Two months later he presented with high fever, night sweats and a weight loss of 11 kg. Blood cultures showed the presence of Campylobacter fetus. An echocardiogram demonstrated vegetations on the pacemaker probes, not visualised on the ultrasound performed two months before. After extraction of the leads and pacemaker and another four weeks of intravenous antibiotherapy (imipenem/cilastatin and gentamicin), a new system was implanted. The patient regained weight and did not show any recurrence of symptoms at one-year followup.