(IIP Infection; Pain Pump Infection)

Definition

An intrathecal infusion pump (IIP) is a device placed just under the skin. A tube allows the device to pass pain medicine to the spine. It will help decrease pain by placing medicine right where it is needed. A pain pump can also decrease the amount of medicine that is needed to manage pain.


An infection can grow on this device or in the tube. It can spread from the device to nearby tissue.


Causes

Germs can attach to the device as it is being placed or once it is inside. They can also enter the device when new medicine is passed into the device. It is hard for the body to fight germs on or in the device itself. This gives the germs a chance to grow and spread before the body reacts. The germs can pass from the device to nerves and fluid around the spine. There it can cause a serious illness. The infection is most often caused by a bacteria.


Risk Factors

IIP infection is more common in young people.


Factors that may raise the risk of infection are:

  • A pump that is under the skin instead of under tissue
  • Pump replacement
  • Using a feeding tube

Symptoms

You may have these symptoms at the pump site:

  • Redness and swelling
  • Discharge
  • Fever or chills in some

Diagnosis

The doctor will examine the area. The infection may be clear on exam.


Blood and fluid around the spine and brain may be tested. They can show signs of infection.


Images of the area may also be taken. This can be done with:

  • X-rays
  • MRI scan
  • Ultrasound
  • CT scan

Treatment

Antibiotics will be given to help fight the infection.


Surgery may be needed to treat more severe infections. The pump may need to be removed. Antibiotics will also be placed into the area. The pump may be replaced once the infection has cleared.

Prevention

Antibiotics may be given before a pump is placed. It can lower the risk of an infection. Tubes and needles used with the device will also be carefully cleaned and used to lower risk of infection.


RESOURCES

CANADIAN RESOURCES

References

Central nervous system device infections. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T921618/Central-nervous-system-device-infections  . Updated April 17, 2018. Accessed May 11, 2018.