title: [A case of stage IV b pancreatic cancer in which a catheter-related infection caused by epidural/subcutaneous reservoir therapy affected palliative home-based care].
abstract: We report the case of a patient with a stage IV b pancreatic cancer in which epidural/subcutaneous reservoir therapy was effective for pain control. However, a catheter-related infection caused by methicillin-resistant Staphylococcus aureus (MRSA)was occurred. In recent years, the number of cancer patients desiring palliative home-based care in Japan has increased. Epidural/subcutaneous reservoir therapy is often offered to relieve refractory pain, and to reduce the side effects of systemic administration of opioids, such as drowsiness, in homecare patients. We believe that this patient may have been able to continue home-based care if the catheter-related infection did not occur, because a significant improvement was calculated in the pain level by the numerical rating scale(NRS)observed. It is important to establish and share common strict guidelines between hospital doctors and general practitioners for the management of the subcutaneous catheter and reservoir therapy in order to prevent catheter-related infections over a long period.
authors.affiliation: The Jikei University Daisan Hospital.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inoue
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Sakuyama
authors.forename: Akitaka
authors.initials: A
authors.lastname: Yoshizawa
authors.forename: Eijiroh
authors.initials: E
authors.lastname: Nagasaki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Uwagawa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Saitoh
authors.forename: Keisuke
authors.initials: K
authors.lastname: Aiba
mesh_terms: D000369:Aged, 80 and over; D015360:Analgesia, Epidural; D055499:Catheter-Related Infections; D017809:Fatal Outcome; D005260:Female; D006699:Home Care Services; D006801:Humans; D009367:Neoplasm Staging; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*