Glomerulonephritis and Septic Pulmonary Embolism: A Rare but Life-Threatening Complication of Permanent Pacemaker Implantation

TL;DR

A rare but dangerous complication of permanent pacemaker implantation is glomerulonephritis and septic pulmonary embolism caused by infection.

Contribution

The paper presents a case of CIED-IE leading to IRGN and septic embolism in an adult.

Findings

IRGN in adults has a poor prognosis compared to childhood cases.

CIED-IE is increasingly common and often caused by staphylococci or other Gram-positive bacteria.

The case highlights the challenges in managing CIED-IE and its complications.

Abstract

Infection-related glomerulonephritis (IRGN) is an immunologically mediated glomerular injury triggered by an extrarenal infection. Infective endocarditis-associated glomerular nephritis is an entity caused by infection of the cardiac valves. IRGN is most common in children, and post-streptococcal glomerulonephritis (PSGN) is commonest in the age group of 2-14 years. In contrast to childhood PSGN and epidemic PSGN, which usually resolve completely with antibiotics, IRGN in adults has a guarded prognosis. Cardiovascular implantable electronic device-associated infective endocarditis (CIED-IE) is a phenomenon for which the incidence is on the rise (0.1-5.1%). The most frequent CIED-IE pathogens were staphylococci or other Gram-positive bacteria. CIED-IE poses difficult management problems for the clinician. We present the case of a 50-year-old patient with a pacemaker who was found to have infective endocarditis and septic embolism.

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