Cardiac implantable electronic devices infections are becoming increasingly frequent with more of these devices being implanted in elderly patients with multiple comorbidities. They carry high morbidity and mortality if not treated promptly, which often entails removal of the entire system. Early recognition is paramount, and a multidisciplinary team is required. In this case report, we go through unique and challenging presentations of such patients with cardiac implantable electronic devices-related issues who presented to our institution, and we describe individual approaches to management and review the literature.