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A Case of Transverse Myelitis With an Intrathecal Pump: A Case Report
Jimmy Wen1, Shannon Dwyer1, Burhaan Syed1
1California Northstate University College of Medicine, Elk Grove, CA.
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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