case_images: PMC9188390_01
case_images: The patient's pacemaker pouch.
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case_images: August 2021 and was diagnosed as having: an artificial permanent pacemaker implantation; coronary atherosclerotic heart disease; and hypertension grade II. About 2 weeks after the operation, the patient's pacemaker pouch began to show redness and elicited pain (Figure 1).
case_images: On August 29, 2021, X-ray images were taken of the patient chest. The X-rays showed that increased density at the arrow, considering possible infection.
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case_images: August 29, 2021, the patient underwent chest X-ray examination, which showed a high-density from the pacemaker pouch, suggesting infection (Figure 2). Antibiotic treatment, with routine consideration to cover Gram-positive bacteria, vancomycin treatment after admission, vancomycin treatment for 3 days, exudation and ulcer, suggested that the effect of vancomycin was not satisfactory.
case_images: (A) Original culture result of Gordonia crocea (chocolate plate); (B) Gordonia crocea Gram staining result; (C) Gordonia crocea weakly acid-fast result.
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case_images: PMC9188390_01_IDR-15-2915-g0003.jpg
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case_images: Seventy-two-hour later, yellowish, wrinkled and dry colonies were observed on the non-inhibitor chocolate agar plates, with colony sizes about 2-3 mm (Figure 3A). The results of Gram staining showed that the strain was Gram-positive bacilli (Figure 3B) and had weak acid-fast staining positive (Figure 3C).