Rare Enough ? Cardiac Device Related Pocket Infection due to Mycobacterium fortuitum

Nontuberculous mycobacteria are rare causes of cardiac implantable electronic device (CIED) pocket infections. The defibrillators are more prone to infections when compared to pacemakers. Pocket infections may lead to device-related endocarditis, so preventing them is key. Presence of acid-fast bacilli on smears may aid in the diagnosis. These bacteria grow within 3-7 days on standard agar blood culture media. Accurate diagnosis requires PCR-restriction enzyme analysis. More often than not, with these infections, it is strongly recommended that entire device or hardware be removed urgently. A minimum of 4 months of therapy with at least two agents is necessary.