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Candida albicans Pacemaker Lead Endocarditis: A Case Report

Summary

A 68-year-old diabetic man with a pacemaker developed a serious fungal heart infection caused by Candida albicans. Doctors diagnosed it through blood tests and heart imaging that showed abnormal growths on the pacemaker lead. He was successfully treated by surgically removing the pacemaker and giving him strong antifungal medications for six weeks. The patient fully recovered with no complications.

Background

Fungal endocarditis (FE) is a rare but life-threatening complication of permanent cardiac pacing, most commonly caused by Candida and Aspergillus species. Candida albicans accounts for 30-40% of fungal endocarditis cases and is associated with high morbidity and mortality rates exceeding 70%. Early diagnosis and combined surgical and medical management are crucial for improving outcomes.

Objective

To report a case of fungal pacemaker lead endocarditis caused by Candida albicans in a 68-year-old patient and demonstrate successful treatment using a multidisciplinary approach combining surgical explantation and antifungal therapy.

Results

Blood cultures positive for Candida albicans with budding and filamentous yeast cells identified. Transesophageal echocardiography showed a 28×13 mm vegetation on the ventricular lead. The organism was susceptible to all tested antifungal agents. Patient became afebrile, achieved sterile blood cultures by day 12, and remained asymptomatic with no relapse at four months follow-up.

Conclusion

Combined surgical explantation and antifungal therapy successfully treated Candida albicans pacemaker lead endocarditis. This case emphasizes the importance of high clinical suspicion, prompt microbiological diagnosis, and multidisciplinary management including both medical and surgical interventions to reduce mortality in fungal endocarditis.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 40161077, DOI: 10.7759/cureus.79824
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