title: [Continuous infusion of baclofen and an antibiotic for treating meningitis related to refilling of an intrathecal infusion pump reservoir].
abstract: Baclofen via intrathecal infusion pump is a widely used treatment severe spasticity. Complications are rare and usually mild, though they can also be serious. The sudden discontinuation of intrathecal baclofen may have significant adverse effects. We report the case of a 59-year-old man with chronic spasticity and torsion dystonia who developed meningitis due to Staphylococcus epidermidis due to contamination of the intrathecal, infusion pump reservoir during refilling. It was decided to treat the patient by administering vancomycin through the pump, together with the baclofen. We believe that changing the intrathecal perfusion pump is not necessary as the first measure to take in these cases. Combined infusion of baclofen and an antibiotic through the pump makes it possible to maintain antispastic treatment, sterilize the pump reservoir and tubes, and effectively treat infections that develop during use of these systems.
authors.affiliation: Consorcio Hospital General Universitario de Valencia. alhegor@alumni.uv.es
authors.forename: A
authors.initials: A
authors.lastname: Herranz Gordo
authors.forename: V
authors.initials: V
authors.lastname: Villanueva Pérez
authors.forename: A
authors.initials: A
authors.lastname: Pérez Cervelló
authors.forename: G
authors.initials: G
authors.lastname: Cerdá Olmedo
authors.forename: M A
authors.initials: MA
authors.lastname: Pallardó López
authors.forename: J A
authors.initials: JA
authors.lastname: De Andrés Ibáñez
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000627:therapeutic use; D001418:Baclofen / Q000008:administration & dosage* / Q000627:therapeutic use; D004422:Dystonia Musculorum Deformans / Q000188:drug therapy; D004866:Equipment Contamination; D018718:Home Infusion Therapy / Q000295:instrumentation; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007263:Infusions, Parenteral / Q000295:instrumentation; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology; D013212:Staphylococcus epidermidis; D014640:Vancomycin / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D014640:Vancomycin; D001418:Baclofen