A 63-year-old male with a history of pacemaker insertion 2 weeks ago presents with a 2-day history of pain and swelling over the pacemaker area. On inspection, his temperature is 36.8C, heart rate 70/minute, respiratory rate 18/min, blood pressure 140/80, SpO2 98% on room air. There is an erythematous, tender swelling over the pacemaker site, with no pus exudate. What is the next immediate step?

Cardiac Device Related Infection

Quiz
•
Other
•
University
•
Medium
Bushra Johari
Used 5+ times
FREE Resource
10 questions
Show all answers
1.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Surgical debridement
Obtain two sets of blood culture
Transoesophageal echocardiogram
Transthoracic echocardiogram
2.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 50-year-old female presents with a 3-day history of pain over her implantable cardioverter defibrillator (ICD) site. On inspection, she is afebrile with stable vital signs. There is some erythema and swelling over the ICD site, with no obvious pus discharge. One set of blood cultures was negative. What is the most likely diagnosis?
Definite CIED infection
Deep pocket infection
Probable CIED infection
Superficial pocket infection
Answer explanation
Superficial pocket infection as patient is afebrile and blood cultures are negative
3.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 65-year old male with a history of hypertension, diabetes mellitus and pacemaker inserted 6 weeks prior was initially admitted to the respiratory ward with a diagnosis of community acquired pneumonia. He developed new neurological deficits while in the ward and a CT brain revealed multiple intracerebral haemorrhage. Further history revealed a low grade fever and generalized malaise of 3 weeks duration. Upon further examination, there is erythema around the pacemaker site. What is the likely diagnosis?
Definite CIED infection with IE and embolic involvement
Possible CIED infection with IE and embolic involvement
Definite CIED infection with IE and immunological phenomenon
Possible IE with embolic involvement
Answer explanation
Possible CIED infection with IE and embolic involvement. (1 major criteria [clinical evidence of CIED infection] + 1 minor criteria [fever, possible vascular phenomenon])
4.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 75-year-old female with ESRD and a history of ICD insertion presents with a 6-day history of fevers and chills. Her preliminary blood cultures results show gram positive cocci. What is the most likely causative organism?
Coagulase negative Staphylococcus
Corynebacterium striatum
Enterococcus spp.
Streptococcus spp.
Answer explanation
Coagulase negative Staphylococcus is the commonest, followed by S. aureus.
5.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 70-year-old female with a history of rheumatic mitral stenosis and recent ICD insertion presents with 4 days of fevers and night sweats, malaise, and multiple small erythematous lesions on the soles of the feet. Echocardiogram reveals lead and valve vegetations. Which of the following is the most likely organism to be isolated from blood cultures?
Escherichia coli
Pseudomonas aeruginosa
Staphylococcus aureus
Streptococcus spp.
Answer explanation
Staphylococcus aureus (For CIED infections: CoNS commonest, followed by S. aureus, followed by GNB)
6.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 70-year-old male with a history of mitral valve replacement and an ICD is admitted with fever for 2 weeks. There is erythema around the ICD site and pus was drained. Blood cultures grew methicillin resistant CoNS and echocardiogram showed vegetation on the leads and the mitral valves.
Which of the following is the MOST appropriate management regarding this patient’s ICD and leads?
Consider removal of device if persistent bacteraemia
Removal of device and antibiotic therapy for 2 weeks after extraction
Removal of device and antibiotic therapy for 4 weeks after extraction
Removal of device and antibiotic therapy for 4 - 6 weeks after extraction
Answer explanation
Removal of device and antibiotic therapy for 4 - 6 weeks (CIED infection with prosthetic valve endocarditis)
7.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 60-year old male presents with redness and slight tenderness over his pacemaker site which was inserted 1 week ago. He is otherwise well with normal vital signs. On examination, there is slight erythema over the pacemaker site, with no evidence of pus. His blood cultures were negative and transoesophageal echo was normal. What is the best management for this patient?
Remove entire CIED
Retain CIED
Retain CIED and intravenous antibiotics for 7 - 10 days
Retain CIED and oral antibiotics for 7 - 10 days
Answer explanation
Retain CIED and oral antibiotics for 7 - 10 days (Superficial incisional infection)
Create a free account and access millions of resources
Similar Resources on Wayground
15 questions
Kardiologia

Quiz
•
University
14 questions
Immunity

Quiz
•
University
10 questions
Fish Health

Quiz
•
University
15 questions
Các hoạt động tại cảng ICD

Quiz
•
University
8 questions
HCP 103 CLO 3 Mastery Assessment

Quiz
•
University
14 questions
ĐLVT

Quiz
•
University
10 questions
Definitions of Abnormality & Classification and Diagnosis

Quiz
•
University
10 questions
First Aid

Quiz
•
KG - Professional Dev...
Popular Resources on Wayground
25 questions
Equations of Circles

Quiz
•
10th - 11th Grade
30 questions
Week 5 Memory Builder 1 (Multiplication and Division Facts)

Quiz
•
9th Grade
33 questions
Unit 3 Summative - Summer School: Immune System

Quiz
•
10th Grade
10 questions
Writing and Identifying Ratios Practice

Quiz
•
5th - 6th Grade
36 questions
Prime and Composite Numbers

Quiz
•
5th Grade
14 questions
Exterior and Interior angles of Polygons

Quiz
•
8th Grade
37 questions
Camp Re-cap Week 1 (no regression)

Quiz
•
9th - 12th Grade
46 questions
Biology Semester 1 Review

Quiz
•
10th Grade