Abstract
Intrathecal drug delivery systems are widely used to treat intractable cancer and chronic pain. However, they are rarely used in cases that require pain control in the acute phase, such as Fournier's gangrene. Here, we report a case, in collaboration with our pain management department, in which an intrathecal drug delivery system was effective in controlling pain in an individual with a skin defect caused by Fournier's gangrene. A 71-year-old man with diabetes and alcoholic cirrhosis presented with fever in our emergency department and was diagnosed with a urinary tract infection. However, the subsequent development of Fournier's gangrene due to infection with preexisting hidradenitis suppurativa necessitated pain management. This was successfully achieved by injecting bupivacaine following the placement of an intrathecal drug delivery system via a port on the lateral chest wall. The resulting pain relief permitted adequate debridement, wound care, and skin grafting. The patient was rehabilitated and discharged on the 89th day of hospitalization with an independent gait. The favorable outcome of this case demonstrates that intrathecal drug delivery systems may be instrumental in providing pain relief, even in the acute phase, and facilitating enhanced patient care.
