Mycobacterium Tuberculosis Infection at Pacemaker Implantati
Infections after pacemaker implantation are very infrequent but they can lead to serious consequences. Pacemaker infections by mycobacteria are rare and only few cases have been reported in medical literature. Here we report a pacemaker pocket infection by Mycobacterium tuberculosis.

Case Report
A 68 yr old male who had undergone pacemaker implantation 6 years ago due to complete heart block, presented with complaints of painless swelling over right side of chest (pacemaker implantation site) with purulent discharge (Figure 1). Patient did not have any constitutional symptoms like fever, loss of appetite and weight loss. Swab from implantation site was sent for Gram staining, ZN staining, bacterial and mycobacterial cultures. Chest X-ray revealed no evidence of pulmonary tuberculosis. 2D-Echocardiogram showed normal ejection fraction with no evidence of pericardial tuberculosis. Prophylactic antibiotics were started. Infected pulse generator was removed with insertion of new pulse generator on left side. Bacterial culture was negative. Smear and culture for AFB was positive for Mycobacterium tuberculosis, sensitive to standard first line chemotherapy drugs. Antibiotics were stopped and he was treated with Isoniazid, Rifampicin, Ethambutol and Pyrazinamide for two months followed by Isoniazid and Rifampicin for four months according to body weight. Patient had complete resolution of swelling after 6 months of treatment with anti-tuberculous therapy....