Case reports and a preliminary study have suggested that 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) scans may be useful for the diagnosis of pacemaker infection. A 75-year-old man was implanted with a dual-chamber pacemaker 8 years ago for complete atrioventricular block. One year after implantation, he experienced a first septic episode. The causal pathogen identified by haemocultures was peregrinum , a non-tuberculous mycobacterium. Complete investigation could not reveal the origin of the infection. The pacing system was left in place and he was treated for several months with clarithromycin and ciprofloxacin.
After 8 years without objective signs of active infection, the patient was hospitalized for an episode of fever of unknown origin. The source remained uncertain after 1 week of comprehensive investigation. No signs of pacemaker pocket infection were observed and transoesophageal echocardiography ( Fig. 1 ) and haemocultures were negative.
