["Circumscribed defibrillator erythema": a differential diagnostic and therapeutic problem in differential occult defibrillator infection diagnosis]. / "Zirkumstriptes Defibrillator-Erythem": ein differentialdiagnostisches und -therapeutisches Problem in der Abgrenzung zur okkulten Defibrillatorinfektion.

We report about three out of 452 patients (pts) (< 1 %) with circumscribed erythema (E) after implantation of an automatic cardioverter defibrillator (ICD). ICD-E occurred in two pts after pulse generator replacements and in one pt after initial ICD implantation. There were no clinical signs of inflammation and laboratory and technical finding were completely normal. Allergic reactions could be ruled out in all pts. Local or systemic drug treatment did not influence the ICD-E. During a follow-up of 28, 10 or 9 months, the ICD-E is still present in two patients and much improved in one pt without any treatment. We did not observe an infection in any of the pts. Our data show that the ICD-E occur rarely after ICD implantation and no special treatment is necessary if an infection or allergic reaction has been excluded. Nevertheless, it is sometimes difficult to exclude in those pts an atypical infection.