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Severe aortic stenosis — RCPSC IM MCQ

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HardCardiologySevere aortic stenosisRCPSC IM

A patient with a permanent pacemaker develops persistent S aureus bacteremia. TEE shows a mobile lead vegetation and there is no other focus. What is the key definitive management principle?

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Correct answer: D — Arrange device and lead extraction plus targeted IV antibiotics

Definite CIED infection requires complete system extraction plus targeted antimicrobial therapy; retained infected leads lead to relapse. Generator-only exchange, suppressive therapy alone, anticoagulation, or waiting for cultures to clear fails source control.

Reference: Public Health Ontario, Infectious Diseases Resources: https://www.publichealthontario.ca/