title: Use Of External Intrathecal Infusion Pumps In The Management Of Septic Complications: A Case Report.
abstract: Spasticity is a motor disorder with an increased muscle tone, typically associated with spasms, weakness and lack of coordination. It is an invalidating and debilitating pathology, characterized by pain, limited autonomy in activities of daily living, development of severe lesions. Spasticity can be adequately treated with physiotherapy, muscle relaxants drugs or topical treatment with botulinic toxin type A. Intrathecal baclofen therapy is very effective in the treatment of severe and generalized spasticity. Sometimes, soft tissues adjacent to the implant intrathecal infusion become infected; removing intrathecal infusion and systemic antibiotic therapy are best solution for clinical cure. However, removing intrathecal baclofen therapy could increase muscle spasticity with enhancement of pain and clonus that can worsen quality of life. In this study, we evaluated clinical improvement after complete healing of the septic focus and implantation of a new infuser.
authors.affiliation: Neuroscience and Sense Organs Department, Physical Medicine and Rehabilitation, University of Bari, Policlinico of Bari, P.zza G. Cesare 11, 70124 Bari, Italy. ricmarv81@hotmail.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Marvulli
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Chiumarulo
authors.forename: Mattia
authors.initials: M
authors.lastname: Nisi
authors.forename: Laura
authors.initials: L
authors.lastname: Barulli
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Megna
authors.forename: Fiore
authors.initials: F
authors.lastname: Pietro
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ianieri
authors.forename: Marisa
authors.initials: M
authors.lastname: Megna
mesh_terms: D000005:Abdomen; D000284:Administration, Oral; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001418:Baclofen / Q000008:administration & dosage* / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D020878:Device Removal; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D058786:GABA-B Receptor Agonists / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007260:Infusion Pumps; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D060186:Infusions, Spinal / Q000009:adverse effects*; D008607:Intellectual Disability / Q000150:complications; D008297:Male; D011782:Quadriplegia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012086:Reoperation; D018805:Sepsis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D012720:Severity of Illness Index; D018461:Soft Tissue Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D058786:GABA-B Receptor Agonists; D001418:Baclofen