Successful In Situ Management of Intrathecal Baclofen Pump-Associated Staphylococcus Epidermidis Meningitis: A Case Report

Objective: Our objective was to report the successful in situ management of Staphylococcus epidermidis meningitis following intrathecal baclofen pump implantation without removing the device. Design: This was a single case report with clinical follow-up. Subjects/Patients: We discuss a 34-year-old tetraplegic patient with severe generalized spasticity due to cerebral anoxia at birth who developed meningitis six weeks after intrathecal baclofen pump implantation. Methods: We used a multidisciplinary management approach. This involved aggressive intravenous and intrathecal antibiotic therapy while preserving the intrathecal baclofen device. Treatment included intravenous Meropenem. This was followed by intravenous Vancomycin and oral Linezolid. Calculated intrathecal Vancomycin was administered through the implanted pump. Results: The treatment resulted in a complete resolution of infection with negative cerebrospinal fluid cultures and polymerase chain reaction analysis. The patient had significant functional improvement throughout treatment with intrathecal baclofen. Six months post-infection, the patient remained stable, with continued efficacy of intrathecal baclofen and no recurrence of infection. Conclusion: In carefully selected patients with intrathecal baclofen pump-associated Staphylococcus epidermidis meningitis, successful in situ management is possible without device removal, preserving functional benefits while achieving infection eradication through aggressive antibiotic therapy.