Bacterial Endocarditis and Right Atrial Vegetation

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Abstract
PACEMAKER-induced endocarditis has traditionally been diagnosed by clinical suspicion and positive blood cultures. The present case shows that echocardiographic techniques can be used to record right-sided vegetation owing to endocarditis induced by an atrioventricular pacemaker. Report of a Case A 62-year-old man with an indwelling pacemaker was hospitalized for cyclic episodes of fever. Eight years previously he had suffered a myocardial infarction, and five years before this admission a permanent transvenous pacemaker electrode had been inserted into the right ventricle. His pacemaker generator was changed 18 months before admission, but had required no further attention. On admission the patient denied dyspnea or chest pain and gave no history of recent dental extractions, skin infections, or instrumentation. He had lost almost 16 kg in the year before admission. His blood pressure was 114/48 mm Hg, his pulse rate was 80 beats per minute, and his temperature was 37 °C. Conjunctivae and

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