skip to main content

CIED Infection — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateBone & Joint InfectionCIED InfectionSCE Infectious Diseases

A 72-year-old man with a permanent pacemaker presents with recurrent fevers and positive blood cultures for coagulase-negative staphylococci over 6 weeks. TOE shows a 1.5 cm mobile mass on the pacemaker lead. What is the definitive management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Complete device extraction plus prolonged IV antibiotics

Cardiac implantable electronic device (CIED) infection with lead vegetation requires complete system extraction (generator and all leads) plus prolonged IV antibiotics (typically 4–6 weeks). Without device removal, cure rates are <20% due to biofilm formation. AHA 2024 scientific statement and ESC 2023 guidelines strongly recommend extraction. Re-implantation, if needed, should be at a different site after blood culture clearance.

Reference: AHA 2024 – CIED infection scientific statement; ESC 2023 – Endocarditis guidelines