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高位颈髓损伤患者鞘内注射巴氯芬泵中存在近平滑念珠菌:感染还是定植?一例报告。

The presence of Candida parapsilosis with intrathecal baclofen pump in a person with high cervical spinal cord injury; infection or colonization? A Case Report.

机构信息

Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, CA, USA.

Division of Neurosurgery, Santa Clara Valley Medical Center, San Jose, CA, USA.

出版信息

Spinal Cord Ser Cases. 2023 Nov 30;9(1):55. doi: 10.1038/s41394-023-00610-5.

Abstract

INTRODUCTION

Intrathecal baclofen (ITB) therapy is an effective method of treating spasticity in persons with spasticity due to spinal cord injury (SCI), but complications are not rare and can include spinal fluid leaks, infection, and catheter/pump malfunction.

CASE PRESENTATION

This study presents information related to an adult male patient with traumatic SCI and a history of two prior ITB pump pocket infections that required removal due to pump infection. The patient then developed skin erosion over the third pump, and the fluid around the pump grew methicillin-sensitive Staphylococcus aureus, diphtheroids, and Candida parapsilosis. The patient was initially treated with antibiotics and anti-fungal medication without removal of the ITB pump. The ITB pump was eventually removed 27 months later, and the fourth pump was implanted 10 months later.

DISCUSSION

ITB pumps can be an effective treatment modality for spasticity in people with SCI; however, complications, including infection, can occur and require pump removal. This case illustrates a case of possible Candida colonization of the ITB pump, which was eventually removed.

摘要

简介

鞘内注射巴氯芬(ITB)疗法是治疗脊髓损伤(SCI)导致痉挛患者痉挛的有效方法,但并不罕见的是,该疗法会出现并发症,包括脑脊液漏、感染和导管/泵故障。

病例介绍

本研究介绍了一位成年男性 SCI 创伤患者的信息,该患者曾有两次因泵感染而需要取出 ITB 泵的病史。随后,患者的第三个泵出现皮肤侵蚀,并且围绕泵的液体中生长出对甲氧西林敏感的金黄色葡萄球菌、类白喉菌和近平滑假丝酵母。患者最初接受了抗生素和抗真菌药物治疗,而没有取出 ITB 泵。27 个月后,最终取出了 ITB 泵,并在 10 个月后植入了第四个泵。

讨论

ITB 泵可有效治疗 SCI 患者的痉挛;然而,包括感染在内的并发症可能会发生,需要取出泵。该病例说明了 ITB 泵可能存在假丝酵母定植的情况,最终该泵被取出。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b44/10689785/35263817eb88/41394_2023_610_Fig1_HTML.jpg

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