Staphylococcal meningitis following synchromed intrathecal pump implant: A case report

Abstract

Staphylococcal meningitis associated with implantation of an intrathecal drug pump for spasticity was successfully treated by intrathecal vancomycin delivered by the same pump. This produced high CSF antibiotic levels, and the pump and catheter system did not have to be removed. We are unable to identify a similar case reported in the literature to date.

Coagulase-Negative Staphylococcal Meningitis in Adults: Clinical Characteristics and Therapeutic Outcomes

“…Of the 14 cultured CoNS strains, S. epidermidis was the most common subtype, accounting for 71% (10/14), and the other subtype, S. haemolyticus, accounted for 29% (4/14). The frequency of appearance of different subtypes of CoNS in bacterial meningitis is consistent with the findings of other reports with S. epidermidis as the most commonly implicated subtype [5][6][7][8][9][10][11]. All 14 cases had a postneurosurgical state with insertion of neurosurgical devices as the underlying condition, and 86% (12 of the 14) of them contracted meningitis nosocomially.…”

“…CoNS were reported to be 52.8% of pathogens of ventriculoperitoneal (V-P) shunt infections in pediatric patients less than 8 years old [3]. However, adult CoNS meningitis has not been examined specifically in the literature [4][5][6][7][8][9][10][11]. In this study, we analyzed the clinical and laboratory characteristics, and therapeutic outcomes of 14 adult patients with CoNS meningitis.…”

Pseudomonas aeruginosa infection in an intrathecal baclofen pump: successful treatment with adjunct intra-reservoir gentamicin

“…5 Later reports Pseudomonas aeruginosa infection in a baclofen pump A Galloway and FZ Falope described the use of intra-reservoir antibiotics with or without pump removal. 2,6,7 In our centre, re®ll of baclofen pumps is always performed in the Day Theatre under aseptic conditions. Fifteen patients are currently receiving intrathecal baclofen because of spasticity from spinal cord dysfunction from spinal cord injury and multiple sclerosis and have been treated for between 3 and 60 months.…”

65 Surgical Management of Spasticity

“…The treatment of pump-related infection often requires the administration of antibiotics through the pump, allowing the device to be retained [15]. Children with extensive involvement of cerebral palsy often have co-morbidities that increase the risk of infection, including malnutrition; skin breakdown or maceration secondary to deformity; stomas and gastrostomy sites; behavioural problems leading to interference with wounds and urinary and faecal incontinence [16].…”