Management of an intrathecal baclofen pump pocket empyema caused by a proximal vesicocutaneous fistula: A case report

Abstract

Background: Intrathecal baclofen infusing pumps are nowadays commonly implanted in patients suffering from severe, intractable spasticity with a background of multiple sclerosis. Although intrathecal baclofen therapy is considered a safe therapeutic modality, complications are unavoidable and broadly categorized as mechanical and infectious. In the instance of a pump pocket infection, a surgical explanation of the pump is often necessary to treat the infection. Case Description: We present the rare case of a 60-year-old woman who was admitted emergently to our clinic with a subcutaneous pump pocket empyema caused by proximal vesicocutaneous fistulas. The patient underwent explantation of the pump and otherwise had an uncomplicated perioperative course. Conclusion: The surgical explanation of the baclofen pump and antibiotic treatment were sufficient to treat the pump pocket empyema in this instance. To the best of our knowledge, this is the first report of a pump pocket empyema formed in the proximity of a vesicocutaneous fistula.