An 80-year-old man had a secondary prevention defibrillator in place for treatment of sustained ventricular tachycardia. After a generator replacement several years later, he developed a series of apparent pulse generator infections requiring extraction. Each purulent appearing pocket eruption was culture negative. Eventually, he was diagnosed with a delayed hypersensitivity reaction to triclosan, an antibacterial that is commonly impregnated in surgical sutures. The evaluation for this is difficult and can be misleading. This entity should be considered in the differential diagnosis of patients with culture negative CIED infections.
