Introduction

Intrathecal baclofen (ITB) therapy is an effective method of treating spasticity in persons with spasticity due to spinal cord injury (SCI), but complications are not rare and can include spinal fluid leaks, infection, and catheter/pump malfunction.

Case presentation

This study presents information related to an adult male patient with traumatic SCI and a history of two prior ITB pump pocket infections that required removal due to pump infection. The patient then developed skin erosion over the third pump, and the fluid around the pump grew methicillin-sensitive Staphylococcus aureus, diphtheroids, and Candida parapsilosis. The patient was initially treated with antibiotics and anti-fungal medication without removal of the ITB pump. The ITB pump was eventually removed 27 months later, and the fourth pump was implanted 10 months later.

Discussion

ITB pumps can be an effective treatment modality for spasticity in people with SCI; however, complications, including infection, can occur and require pump removal. This case illustrates a case of possible Candida colonization of the ITB pump, which was eventually removed.

中文翻译：

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高位颈髓损伤患者鞘内注射巴氯芬泵时存在近平滑念珠菌；感染还是定植？案例报告

介绍

鞘内注射巴氯芬 (ITB) 疗法是治疗脊髓损伤 (SCI) 引起的痉挛患者的有效方法，但并发症并不罕见，包括脊髓液渗漏、感染和导管/泵故障。

案例展示

本研究提供了一名患有创伤性 SCI 的成年男性患者的相关信息，该患者之前有两次 ITB 泵袋感染史，由于泵感染而需要切除。然后，患者在第三个泵上出现皮肤糜烂，并且泵周围的液体生长了对甲氧西林敏感的金黄色葡萄球菌、白喉类细菌和近光滑念珠菌。患者最初接受了抗生素和抗真菌药物治疗，但未拆除 ITB 泵。ITB 泵最终在 27 个月后被移除，第四个泵在 10 个月后植入。

讨论

ITB 泵可以成为治疗 SCI 患者痉挛的有效方法；然而，可能会发生包括感染在内的并发症，需要移除泵。该病例说明ITB 泵可能存在念珠菌定植，但最终被移除。