possible pacemaker infection

Hi everyone. I am a 34 woman who had my pacemaker placed on 6/25/07 (St. Jude) for asymptomatic high grade AV block. Since 7/15/07 I have had drainage from my incision site and the site keeps opening more, it is now about halfway open. I was started on Keflex 500mg four times a day. I have seen my EP doc 2 times since then and have been to the ER twice. I am fearful that my pocket will become infected and will need my pacemaker replaced. After 9 days of antibiotics the site is still draining lots of fluid, sometimes pus, sometimes just bloody clear drainage. Any suggestions on what I should do, I was thinking possible second opinion. I am very nervous about losing my pacemaker because with my block I had pauses up to 7 seconds. I also had a lumbar fusion in 1/07 and my ortho doc is nervous that the infection will get in my bloodstream and then affect the screws and plate I have in my back. My EP doc says the infection is superficial and doesn't even think it is infected. Any suggestions?????

4 Comments

Run don't walk!

by auntiesamm - 2007-07-24 02:07:05

Just one suggestion: Run, don't walk to another physician STAT. You have too much to loose by not getting your incision tended to immediately. Ask that they culture the wound to determine what organism, if any, is causing the infection. With MRSA so prevalent in the community now - not just the hospital environment - you can't be too cautious. In more than a year in this PM Club I do not recall anyone posting with such a purulent infection! Your situation is also urgent due to the "foreign bodies" in your spine. Those of us with "bionic" parts know the potential problems with infection. Please get yourself taken care.
Sharon

don't wait

by blessed - 2007-07-24 06:07:49

Hi~ I am a 36 year old female who had a PM put in 12/06. I am also a nurse and have dealt personally with lots of infections and if antibiotics have not helped and your incision is getting worse you need to run, not walk, to another physician. It may be that that the wound is superficial however it is draining and that always means something is going on. You will probably need to be somewhat of a thorn in the doctors side to get this taken care of but I have learned the hard way that is sometimes the only way to catch their attention. When you are young and female we tend to get overlooked for things unless we made them take notice~ it doesn't mean we have to be mean and rude but more forceful to get our point across. Do you have a regular family practice or internal med doctor you could go to? Good luck with everything and let us know how things are going.
Blessings,
Tammy

pacemaker incision infection

by Vai - 2007-07-24 11:07:41

The incision for the pacemaker should not be giving you so much problem healing. Many of us have had trouble-free healing of the wound. I suggest you get some experienced help on wound management. A couple of suggestions
- keep the wound absolutely very dry
- clean it with antiseptic or surgical saline every alternate day. No water, please.
- keep absolutely clean or sterile bandage only when necessary (or when in contact with clothing).
- apply some antiseptic cream on the skin next to the wound but NOT in the wound itself
- expose the wound to some sunlight to promote healing.

I had same experience in a surgical wound for some other surgery (not pacemaker) and the wound healed in a way similar to your experience. Lots of drainage (some blood, little pus, some clear fluids etc) for some 3-4 weeks. The opening should not be more than half-inch at the most. My nurse applied some sterile surgical tape strips over the gaping wound mainly to keep it from stretching open further but allowed space for the drainage which she explained is part of the healing process. Watch out though for any redness, soreness, pain, inflammation which are signs of infection. Otherwise the drainage itself is not a problem.

Hope this help,

Possible pacemaker infection

by BeckyM - 2007-07-28 10:07:12

Thanks for all of the feedback. I have been to a ID and he also thinks it is a superficial infection caused by and underlying suture that he has removed. He started my on Bactrim which I found I was allergic to and now started on Amoxicillin. He did culture my wound and told me it has strep in it. After I obtained a copy of the report found out it actually has e-coli in it. I am kind of not surprised, seems as though many people in healthcare don't know how to wear gloves. I work as a Medical Assistant and would never think to remove steri strips or dress a wound without wearing gloves. I tried to call ID back and question about the e-coli but was told he was gone for the day. I have to check in with him and will defintely ask him. I will let you know what happens. I am so glad that there is a club like this where anyone can get so much support for people that they don't even know. Thanks to everyone.

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I am just thankful that I am alive and that even though I have this pacemaker it is not the end of the world.