Septic Shock due to Implantable Cardiac Defibrillator Related Infection.

Infection is an important complication of cardiac device implantation. We report the case of a 61 year old patient presenting with septic shock caused by cardiac device infection (CDI) three-weeks after device implantation. At initial presentation, there was an absence of both localising signs and echocardiographic evidence of CDI. Later, Staphylococcus aureus was cultured from blood and the pre-pectoral pocket. 48 hours after admission the device and leads were explanted in theatre by simple traction. Despite appropriate antibiotics and full supportive care (including haemofiltration, ventilation and inotropic support), the patient died on day six. Cardiac device infection may present with septic shock in the absence of localising features. A high index of suspicion is required, particularly for early CDI.