Juniper Publishers - Management of Intrathecal Pump Site Infection in a Patient with Metastatic Breast Cancer without the Removal of the System, a Case Report - Journal of Anesthesia & Intensive Care Medicine (JAICM)

Juniper Publishers - Open Access Journal of Journal of Anesthesia & Intensive Care Medicine

Management of Intrathecal Pump Site Infection in a Patient with Metastatic Breast Cancer without the Removal of the System, a Case Report

Authored by Cyrus Yazdi

Background: Intrathecal delivery of pain medication with an implantable infusion pump is being increasingly used for management of intractable pain in cancer patients. Infection of an intrathecal pump system is a rare but dangerous complication and usually leads to the removal of the whole system.
Case-Presentation: The author presents the case of a 69 year old woman who was diagnosed with metastatic breast cancer at presentation in 2009. She was treated systematically with chemotherapy and radiotherapy and underwent intrathecal pump implantation for targeted opioid delivery. Seven months after the implant, and a in a location of previous radiotherapy, she developed an infection at the site of the catheter insertion with exposure of the catheter itself. Clinically she presented with signs of local infection, high white blood cell count and back pain.She was treated with extensive surgical debridement of her back wound, removal the exposed intrathecal pump catheter and was started on intravenous ertapenem and later transitioned to levofloxacin and rifampicin for the duration of 3 months.
Conclusion: The author reports a case of infection following implantation of intrathecal pump in a cancer patient can be treated with intravenous antibiotics without the removal of the intrathecal pump system.


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