Surgical-site infection, spinal cord abscess, and catheter tip granuloma are known but rare complications of intrathecal drug delivery systems (IDDS). To date, there are no published cases of brain abscess in a patient with an IDDS. In this study, we report a case of a cancer patient with an IDDS for management of cancer pain who developed a brain abscess with profound mental status changes and clinical management challenges.
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References
1.
FollettK, Boortz-MarxRL, DrakeJM, et al.: Prevention and management of intrathecal drug delivery and spinal cord stimulation system infections. Anesthesiology, 2004; 100:1582–1594.
2.
FjelstadAB, HommelstadJ, SortebergA: Infections related to intrathecal baclofen therapy in children and adults: Frequency and risk factors. J Neurosurg Pediatr, 2009; 4:487–493.
3.
LevinAB, SperlingKB: Complications associated with infusion pumps implanted for spasticity. Stereotact Funct Neurosurg, 1995; 65:147–151.
4.
BennettMI, TaiYM, SymondsJM: Staphylococcal meningitis following Synchromed intrathecal pump implant: A case report. Pain, 1994; 56:243–244.
5.
ZedPJ, StiverHG, DevonshireV, et al.: Continuous intrathecal pump infusion of baclofen with antibiotic drugs for treatment of pump-associated meningitis. Case report. J Neurosurg, 2000; 92:347–349.
6.
AliabadiH, OsenbachRK: Intrathecal drug delivery device infection and meningitis due to Mycobacterium fortuitum: A case report. Neuromodulation, 2008; 11:311–314.
7.
AbrechtCR, GreenbergP, SongE, et al.: A contemporary medicolegal analysis of implanted devices for chronic pain management. Anesth Analg, 2017; 124:1304–1310.
8.
KamranS, WrightBD: Complications of intrathecal drug delivery systems. Neuromodulation, 2001; 4:111–115.
9.
TurnerJA, SearsJM, LoeserJD: Programmable intrathecal opioid delivery systems for chronic noncancer pain: A systematic review of effectiveness and complications. Clin J Pain, 2007; 23:180–195.
10.
Helweg-LarsenJ, AstradssonA, RichhallH, et al.: Pyogenic brain abscess, a 15 year survey. BMC Infect Dis, 2012; 12:332.
11.
UdayakumaranS, OnyiaCU, KumarRK: Forgotten? Not yet. Cardiogenic brain abscess in children: A case series-based review. World Neurosurg, 2017; 107:124–129.
12.
MoazzamAA, RajagopalSM, SedghizadehPP, et al.: Intracranial bacterial infections of oral origin. Clin Neurosci, 2015; 22:800–806.
13.
CarpenterJ, StapletonS, HollimanR: Retrospective analysis of 49 cases of brain abscess and review of the literature. Eur J Clin Microbiol Infect Dis, 2007; 26:1–11.
14.
WhileyRA, FraserH, HardieJM, BeightonD: Phenotypic differentiation of Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus strains within the Streptococcus milleri group. J Clin Microbiol, 1990; 28:1497–1501.
15.
GiulianoS, RubiniG, ConteA, et al.: Streptococcus anginosus group disseminated infection: Case report and review of literature. Infez Med, 2012; 20:145–154.
16.
NayfeR, AschaMS, RehmusEH: Esophageal Squamous Cell Carcinoma Presenting with Streptococcus intermedius Cerebral Abscess. Case Rep Pathol, 2017; 2017:5819676.
17.
MatsushitaM, HajiroK, OkazakiK, et al.: Endophthalmitis with brain, lung, and liver abscesses associated with an occult colon cancer. Am J Gastroenterol, 2000; 95:3664–3665.