The following is a summary of “Presence of Candida parapsilosis with intrathecal baclofen pump in a person with high cervical spinal cord injury; infection or colonization? A Case Report,” published in the November 2023 issue of Neurology by Chan et al.

Intrathecal baclofen (ITB) therapy is a widely recognized and efficacious method used to manage spasticity among individuals affected by spinal cord injury (SCI). Despite its proven effectiveness, this treatment modality is not without complications, encompassing spinal fluid leaks, infections, and potential malfunctions in catheters or pumps.

The case presented here revolves around an adult male patient with a history of traumatic SCI. This individual had encountered two prior infections within the ITB pump pocket, leading to the necessary removal of the pump due to the presence of infection. Subsequently, the patient developed skin erosion over the site of the third pump, and the fluid surrounding the pump exhibited the growth of methicillin-sensitive Staphylococcus aureus, diphtheroids, and Candida parapsilosis. 

Initially, the patient underwent a course of treatment involving antibiotics and anti-fungal medication withoutimmediately removingf the ITB pump. However, the pump was eventually removed after 27 months, and the fourth pump was implanted 10 months later.

ITB pumps are recognized as an effective therapeutic approach for managing spasticity among individuals afflicted by SCI. However, complications, such as infections, can arise, necessitating the removal of the pump. This particular case study sheds light on a possible scenario of Candida colonization within the ITB pump, ultimately leading to its removal.

Source: nature.com/articles/s41394-023-00610-5