Treatment of Vagus Nerve Stimulator Pocket Infection without Removal of the Hardware

Abstract

The management of postoperative pocket infections after vagus nerve stimulator implantation is challenging. Most patients present within four weeks after the implantation of the device and Staphylococcus aureus is the most common infecting agent. Standard medical practice involves the complete hardware removal and antibiotics to achieve long-term cure, with the subsequent reimplantation of the device. Attempts to treat these infections without the removal of the hardware led to high infection recurrence rates because of the formation of staphylococcal biofilms on the device. We present a case of vagus nerve stimulator infection treated successfully with a single surgical debridement of the infected wound and six weeks of antibiotic treatment, but without removing the hardware.

Keywords

• biofilms
• epilepsy
• epilepsy surgery
• infection
• rifampicin
• vagus nerve stimulation