Navigating the red: Diagnostic dilemma of erythema and diffuse body rash post- intrathecal baclofen pump implantation

Intrathecal drug delivery system (IDDS) infections can be localized to the pump pocket site and/or the catheter insertion site or become systemic, all potentially resulting in IDDS explant. Given the well-established effectiveness of IDDS for chronic non-cancer pain, cancer-associated pain, and spasticity, clinicians must differentiate between localized and systemic post-operative IDDS infections, as well as identify other causes of post-surgical skin irritation while avoiding unnecessary device explanation and therapy interruption. In this letter-to-the-editor, we describe and discuss the importance of taking a thorough patient history and utilizing both critical clinical decision-making as well as expertise from other subspecialists to care for IDDS patients and navigate problematic skin reactions following implant.