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Hemophilus influenza infection of an implantable insulin-pump pocket
R P Levy1, M D Borchelt, R M Kremer
1Department of Internal Medicine, St. Thomas Medical Center/Summa Health Care System, Akron, Ohio.
Objective:
To increase awareness of adverse events associated with the use of implantable insulin pumps.
Research Design And Methods:
A descriptive case report of a pump implant infection.
Results:
This is a case report of one implanted insulin pump-pocket infection among a series of 15 patients. After exposure to a child with a respiratory infection on PID 30, V.L.C. (the patient) developed a fulminant pump-pocket infection. H. influenza was recovered from it. Despite aggressive antibiotic therapy, the infection could not be controlled. Insulin delivery ceased, and the pump was explanted. The pump-pocket infection rapidly resolved with pump removal, permitting later reimplantation.
Conclusions:
We have adopted the American Heart Association indications and antimicrobial prophylaxis regimens recommended for prevention of endocarditis in patients with prosthetic values for patients with implanted insulin pumps.
Insights
Implantable insulin pump infections can be serious, requiring prompt removal of the device for resolution. This case highlights the risk of pump-pocket infections and the need for vigilant management in diabetes care.
Area of Science:
- Medical Devices
- Infectious Diseases
- Endocrinology
Background:
- Implantable insulin pumps offer continuous insulin delivery for diabetes management.
- Awareness of potential adverse events, such as infections, is crucial for patient safety.
Observation:
- A case of fulminant pump-pocket infection occurred in a patient with an implanted insulin pump.
- The infection developed 30 days post-implantation after exposure to a respiratory infection.
Findings:
- Haemophilus influenzae was identified as the causative agent of the pump-pocket infection.
- Despite aggressive antibiotic treatment, the infection necessitated pump explantation for resolution.
- Successful reimplantation was possible after the infection resolved post-explantation.
Implications:
- This case underscores the risk of device-related infections with implantable insulin pumps.
- Adopting prophylaxis regimens similar to those for prosthetic valves may mitigate infection risk.
- Vigilance and prompt intervention are key to managing implantable insulin pump infections.