横贯脊髓炎伴鞘内泵1例报告。

Pain medicine case reports Pub Date : 2025-06-01
Jimmy Wen, Shannon Dwyer, Burhaan Syed, Sugamjot Badhan, Ramy Khalil, Foad Elahi
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引用次数: 0

摘要

背景:鞘内泵(ITP)是治疗顽固性疼痛的有效工具。我们报告一例罕见的横脊髓炎作为ITP放置的晚期并发症。病例报告:一名60岁女性患者报告双侧进行性下肢无力和感觉丧失后一年半植入ITP。她变得无法行走并出现尿失禁。磁共振成像发现T6至t9中段高信号。腰椎穿刺显示白细胞计数升高,以淋巴细胞为主。患者给予大剂量皮质类固醇和血浆置换治疗,症状未见改善。在此治疗后,ITP被移除,无并发症,送去培养。微细小单胞菌培养阳性,静脉注射氨苄西林/舒巴坦治疗。该患者被转至三级医疗中心接受进一步治疗。结论:本病例要求及早诊断和处理ITP植入后并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case of Transverse Myelitis With an Intrathecal Pump: A Case Report.

Background: Intrathecal pumps (ITP) are an effective tool for patients with intractable pain. We report a rare case of transverse myelitis as a late complication of ITP placement.

Case report: A 60-year-old female patient reported bilateral progressive lower extremity weakness and loss of sensation 1.5 years postimplant of an ITP. She became unable to ambulate and developed urinary incontinence. Magnetic resonance imaging found hyperintense signaling from T6 to mid-T9 level. Lumbar puncture showed an elevated white blood cell count with lymphocyte predominance. The patient was given high-dose corticosteroids and plasmapheresis without improvement in symptoms. Following this treatment, the ITP was removed without complications and was sent for culture. Culture was positive for Parvimonas micra and treated with intravenous ampicillin/sulbactam. The patient was transferred to a tertiary medical center for further treatment.

Conclusions: This case calls for early and prompt diagnosis and management of postimplant complications of an ITP.

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