Chronic Cardiac Resynchronization Therapy-Defibrillator Infection Leading to Sepsis and Bilateral Septic Pulmonary Emboli: A Case Report.

Cardiac implantable electronic devices (CIEDs), including cardiac resynchronization therapy-defibrillators (CRT-Ds) and other pacemaker systems, are widely used in patients with varying degrees of heart failure to improve cardiac function and reduce the risk of sudden cardiac death. Despite their life-saving benefits, infections related to CRT-Ds present significant clinical challenges. These infections can lead to serious complications, including endocarditis, pocket infections, and device-associated bloodstream infections, often resulting in prolonged hospitalization and potentially life-threatening outcomes. Key risk factors include comorbidities such as diabetes, use of immunosuppressive therapy, and procedural complications. Early recognition and timely intervention, typically involving antibiotic therapy and/or device removal, are essential to improving patient outcomes. In this report, we describe a rare case of chronic CRT-D infection complicated by bilateral septic pulmonary emboli and sepsis, which was successfully managed through a multidisciplinary approach involving device extraction and targeted antibiotic therapy with vancomycin and cefepime.