Intrathecal Baclofen Pump Infection With Meningitis: Effective Treatment by Radical Debridement and Intrareservoir Baclofen–Vancomycin Co-Infusion
Autor: | Thomas Liu, Sophelia H. S. Chan, YW Wong, Stella Chim, Nai Shun Tsoi, Paul Aarne Koljonen, Alvin Chi-chung Ho |
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Rok vydání: | 2021 |
Předmět: |
Dystonia
business.industry General Medicine medicine.disease Status dystonicus Empyema body regions 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Anesthesiology and Pain Medicine Baclofen Neurology chemistry Anesthesia medicine Vancomycin Neurology (clinical) Spasticity medicine.symptom Complication business Meningitis 030217 neurology & neurosurgery medicine.drug |
Zdroj: | Neuromodulation: Technology at the Neural Interface. 24:1223-1228 |
ISSN: | 1094-7159 |
Popis: | OBJECTIVES Intrathecal baclofen pump associated central nervous system (CNS) infection and meningitis is a rare but serious complication and may have dire consequences. Due to bacterial biofilm formation, the optimal treatment strategy is usually for removal of the pump, followed by systemic antibiotics for treatment of local and CNS infection. We describe this case of a patient with recurrent Staphylococcus aureus pump site empyema and meningitis leading to status dystonicus, who was successfully managed with radical debridement and intrareservoir baclofen-vancomycin co-infusion. MATERIALS AND METHODS We retrospectively report a case of infected intrathecal baclofen pump with meningitis and provide a full review of literature. CONCLUSIONS To the best of our knowledge, this is the first reported case of intrathecal baclofen (ITB)-associated pump site empyema and meningitis successfully treated with this technique. In selected cases where surgical explantation is deemed not feasible, this method can provide clinicians with an additional option for pump salvage and retention, while eradicating CNS infection and maintaining optimal control of spasticity and dystonia. |
Databáze: | OpenAIRE |
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