Coronary Stent Infection Complicated by Persistent Methicillin-Sensitive Staphylococcus aureus Bacteremia Myocardial Abscess and Pericardial Effusion

A 52-year-old man presented with coronary stent infection complicated by persistent methicillin-sensitive Staphylococcus aureus bacteremia, myocardial abscess, and pericardial effusion treated successfully with medical management. We presented an updated literature review of diagnosis, treatment, and outcomes of coronary stent infections. We recommend that providers have a high index of suspicion in patients with fevers, leukocytosis, bacteremia, and/or new acute coronary syndrome within 30 days of coronary stent placement. Multimethod imaging, including echocardiography, computed tomography, magnetic resonance imaging, and cardiac positron emission tomography, can assist in diagnosis. Although early-onset infection may be effectively treated with medical therapy alone, late-onset infections appear to benefit from antimicrobials and surgical intervention.