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SAB CIED Extraction Despite Neg TOE — SCE Infectious Diseases MCQ

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HardBone & Joint InfectionSAB CIED Extraction Despite Neg TOESCE Infectious Diseases

A patient with a pacemaker has Staphylococcus aureus bacteraemia and definite generator-pocket infection with purulent erosion. What source-control strategy is required?

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Correct answer: D — Complete removal of the generator and all intravascular leads

The best answer is “Complete removal of the generator and all intravascular leads”. Definite cardiac-device infection cannot be cured reliably with antibiotics alone because prosthetic biofilm remains; complete system extraction accompanies active antimicrobial therapy. The ESC guideline covers blood-culture-negative endocarditis, antimicrobial strategy, oral step-down selection and surgical indications.

Reference: 2023 ESC Guidelines for infective endocarditis: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Endocarditis-Guidelines