Marrone E*, Cacciapuoti F, Abate A, Gallucci F, Magliocca A, Mastrobuoni C, Romano C, Saldamarco L, Valentino U and Morella P
Internal Medicine Unit 3, Cardarelli Hospital, Naples, Italy Cardiology Unit, Monaldi Hospital, Naples, Italy
Scientific Tracks Abstracts: Health Sci J
Background: Cryoglobulins are circulating immunoglobulin’s that can precipitate in cold environments and cause Vasculitis. Although associated with hepatitis C infection in up to 90% of cases, cryoglobulinemia has been linked to many other infections, such as infective endocarditis (IE). We present a case of cryoglobulinemic Vasculitis observed in patient with cardiac deviceā?related IE (CDRIE). Case report: A 76-year-old woman, who received a permanent pacemaker implantation for a high-grade AV block in May 2021, was admitted to the hospital complaining dyspnea associated with anemia and a skin rash over her legs in December 2021. Her lab tests showed elevated inflammatory indices, kidney failure, negative Coombs test and an elevated immunoglobulin G (IgG) and M (IgM) cryoglobulins with hepatitis panel negative. Large vegetation on the pacemaker lead was found on transthoracic echocardiogram and blood cultures were positive for coagulasenegative Staphylococcus. An appropriate antibiotic treatment of CDRIE associated with corticosteroid and a surgical intervention was planned. During hospitalization, the patient developed septic and thrombotic emboli in the right pulmonary artery, abscessed pneumonia and death. Conclusions: Despite IE is an uncommon complication after initial pacemaker implantation; it is associated with high rates of morbidity and mortality. IE may present with various clinical situations, such as cryoglobulinemic Vasculitis and that a high index of suspicion and surgical intervention, in addition to aggressive antibiotic therapy may be necessary.
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