Infection at implantation site

My husband received his PM on 5-31-16.  He's young (35) and fit so Dr thought he did him a favor by glueing rather than stapling or stitching.  After 2 weeks (6-14-16) the site had still not healed.  We went in mainly because the site began to smell which indicates infection and also he had flu like symptoms, major nausea, vomitting, chills, fever, etc.  The flu like symptoms began on 6-11-16.

We were told Dr could see the PM when he removed the steri strips.  Not happy is a major under statement.  That same day (6-14-16) he was loaded up with IV antibiotics, had it removed and had a new one implanted on the opposite side.  Cultures were taken and we have not heard the results so we don't yet know what type of infection it is.  My husband was discharged yesterday (6-15-16) and sent home with nausea pills and antibiotics.  His symptoms are the same as they were 5 days ago.  Has anyone else gone through this?  

5 Comments

Similar here

by DampDog - 2016-06-17 06:51:25

I had a somewhat similar experience post implant, though not as severe so it did not necessitate having my device removed.

I had my implant (CRT-D) procedure on 3/2/16 I had stiches and pressure dressing when sent home, by mid afternoon 3/4/16 I had symptoms similar to yourself, nausea, raging fever and generally feeling very unwell. I rang my GP who advised me to call the paramedics. My wound looked OK other than being a little warm and swollen.

I was admitted to coronary care as I was getting some VT’s and they pumped me full of IV Teicoplanin for a week. They then switched that to IV flucloxacillin for another couple of days. It was quite a rough ride initially. They allowed me home 3/12/16 on oral flucloxacillin which continued for another 2 weeks or so.

The consultants approach was we treat all infections as serious from the off. In my case the cultures came back showing I was responding well to the antibiotics so he was confident they had nipped the infection in the bud and it was safe to leave the device in place. What I don’t understand is why they implanted you with a new device while you were still being treated for an infection. Over here at least you must be clear of infection before they will even consider fitting a new device. Typically they remove the old device and use a “life-vest” (external defrib) of some description until the infection is 100% gone.

Some weeks later I had the tail end of a stitch “pop-out” and become slightly sore and reddened and they again jumped on me with another 2 weeks’ worth of antibiotics. In all it must have taken 10 weeks for the wound to close completely.

Obviously, all cases are different and they may well do things differently in the UK.

I hope things go well for you, but you need to be pro-active, if you have the slightest doubt about possible infection get it looked at by someone who has experience with pacemaker implants. Your average GP or nurse will not have the experience. Even a “pimple” is significant.

Hope things go well for you

DD

Infection

by Cabg Patch - 2016-06-17 14:36:24

Yes, been there done that and have a souvenier T shirt. While still a low percentage of the number of implants performed, infections of new implants are on the rise. When I was hospitalized with my infection there were two others who came in with the same problem. 

Personally I believe everything should be removed, leads and generator, and the infection cleared up before re-implanting another device, but it is quite common for doctors to either leave in the device and just treat with anti-biotics or to remove and replace the device and leads at the same time.

My infection reared it's ugly head in January of this year and it wasn't until mid-May that I got rid of all the external bling and got another shiny new CRT-D and three leads. I had everything removed and wore a wound vacuum to help remove infection, an infusion pump to feed anti-biotics into me through a PICC line, and a life vest due to my heart condition. Makes it challenging to sleep at night listening to everything. At one point they had to change from Vancomyicin as my kidneys were shutting down.

I made the surgeon assure me he washed his hands throughly before the procedure. Well actually I fired the first Electrophysiologist, quite publically I might add, for all he put me through. Long, very long story.

Anyway, So far so good, though I do check the site daily for elevated temperature. Wouldn't want to go through all that again. Oh and I was puzzled about your comment on using adhesive to seal the wound. All of my heart surgery has been done that way and I don't think I'd want it any other way. Well except when they super glued my chest together they forgot to align to two sides and now I lean to the left.

Hope your husband is doing better and all goes well...

Snap

by DampDog - 2016-06-17 15:43:01

"When I was hospitalized with my infection there were two others who came in with the same problem."

Same here, I shared the ward with another chap who also had a post implant infection. Though after a little reasearch i did find out that they do almost 1200 implants a year of one type or another device, so probably not surprising there are a few unlucky recipients each year.

The experience has freaked me out somewhat and I'm certainly not relishing the thought of a generator swap in a few years time. Homefully by then it won't be as fresh in my mind.  

Really

by Cabg Patch - 2016-06-17 17:47:14

My device was implanted in Oct and the lead dislodged almost immediately. After a fight they realized I was right and did a lead revision in Dec. Jan is when the infection reared it's ugly head and consensus was the EP caused it. My problem was further exacerbated by the EP stalling on extraction for over a week while I was shuffled around the hospital and the infection doctor ranted they were going to kill me if they didn't get that crap out. Coincidentally my Cardiologist found out (someone on hospital stafff called him) and hit the ceiling. I understand he threatened the EP at the same time I did. I fired the guy the day after everything was yanked out...you just can't make it up.

Infection symptoms

by Nr137 - 2016-06-19 00:39:13

when did your infection symptoms start to go away, when did you begin to feel better?  We went yesterday to get the bandages changed and to let the doc know the symptoms are persisting.  He was given IV antibiotics and set up for home health care to administer IV antibiotics at home for the next 2 weeks.  He still feels lousy, I would think with all the meds given in the hospital from Tuesday till today (Saturday) he'd begin to at least feel better.  Now I'm concerned about his liver with all these antibiotics and amber colored urine.  Waiting to hear back from the doc from my 2 phone calls today...

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