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BACKGROUND Permanent endocavitary pacemaker lead infectious endocarditis is rare. Two new cases are reported. METHODS The first case appeared in a 63-year-old white woman with a permanent endocavitary pacemaker for 3 years. It was caused by Streptococcus bovis, unique to this pathology. The second case was caused by Streptococcus epidermidis in a diabetic 72-year-old woman. In these two cases, the clues to the diagnosis were hemocultures and transesophageal echocardiography. CONCLUSIONS These two cases emphasize the importance of transesophageal echocardiography (TEE) for diagnosis and for driving treatment. Treatment is based on appropriate antibiotics and pacemaker removal. In the second, case, the material was surgically removed under cardiopulmonary bypass because of the size of the infection.
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