Baclofen Pump Infection Due To Wound Breakdown

Consult Page

54F with wound breakdown at the abdominal site of her intrathecal baclofen pump

Initial Imaging

None

Walking Thoughts

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  What are the patient’s vital signs? Is she hemodynamically stable?

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  What is the patient’s neurological exam?

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  Is there concern for sepsis and/or meningitis? Is she on antibiotics or should they be initiated?

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  Why does the patient have a baclofen pump?

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  Where is the wound breakdown and how long has she had this? Is there purulence, drainage, and/or erythema?

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  Is the hardware exposed?

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  Is there concern for pump malfunction? Is there concern for either baclofen overdose or withdrawal?

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  What additional studies (e.g. X-ray, CT, lumbar puncture, bloodwork) need to be ordered?

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  Can this managed by local wound care, or does she require surgery for revision? If so, what should be the timing for surgery?

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  If she needs complete removal of her intrathecal baclofen pump, can she be transitioned to oral baclofen?