Abstract
A 77-year-old female with a history of coronary artery disease status post-coronary artery bypass grafting, aortic stenosis treated with transcatheter aortic valve replacement, and recent dual-chamber pacemaker implantation for high-grade atrioventricular block presented with recurrent syncope, right brachial artery thrombosis, and persistent bacteremia. Blood and thrombus cultures grew Listeria monocytogenes, leading to pacemaker extraction and a prolonged course of antibiotic therapy. This case illustrates the diagnostic challenges associated with systemic Listeria infections in patients with prosthetic devices and emphasizes the importance of early blood culture collection in patients with unexplained clinical symptoms.