Colonic perforation by an intrathecal baclofen pump catheter causing delayed Escherichia coli meningitis

BMJ Case Rep. 2017 Dec 20:2017:bcr2017222539. doi: 10.1136/bcr-2017-222539.

Abstract

Intrathecal baclofen (ITB) delivery via an implanted pump is frequently used for the treatment of spasticity. This is an effective and safe neurosurgical and pharmacological intervention associated with an improvement in patient quality of life. There is, however, a risk of device-related infection. We present a patient with pump-site infection and Escherichia coli meningitis secondary to transcolonic perforation of an intrathecal baclofen pump catheter. While this is rare, we review the intraoperative precautions and best practices that should be taken to prevent and manage this unusual complication.

Keywords: multiple sclerosis; neurosurgery.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Baclofen / administration & dosage*
  • Catheterization / adverse effects*
  • Catheters, Indwelling / adverse effects*
  • Catheters, Indwelling / microbiology
  • Device Removal
  • Female
  • Humans
  • Iatrogenic Disease
  • Infusion Pumps, Implantable / adverse effects*
  • Infusion Pumps, Implantable / microbiology
  • Infusions, Spinal / adverse effects
  • Intestinal Perforation / etiology
  • Intestinal Perforation / microbiology*
  • Meningitis, Escherichia coli / etiology
  • Meningitis, Escherichia coli / microbiology*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Multiple Sclerosis / drug therapy*
  • Muscle Relaxants, Central / administration & dosage*
  • Persons with Disabilities
  • Recurrence
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Muscle Relaxants, Central
  • Baclofen