Abstract
We report a case of an infected subcutaneous port for intrathecal analgesia treated by conservative antibiotic therapy. The port was not removed. The patient was a female in her 50s with intractable pelvic cancer pain of rectal cancer recurrence. Pain was not relieved with irradiation, phenol saddle block, or high-dose opioids. Because intravenous morphine provoked delirium, intrathecal analgesia with subcutaneous port was installed, which enabled her supine position. On the 27th day after installation, bacterial meningitis occurred via this port. The authors respected the patient's wish to avoid morphine-induced delirium, and intravenous and intrathecal antibiotics infusion preceded without port removal. Meningitis was completely improved on the 75th day after installation, and six months later, the patient died at home with complete pain relief (morphine 8 mg/day; bupivacaine 50 mg/day). Although it is common to remove the infected port, nonremoval is also suggested.
