[Clinical suspicion of vertebral osteomielitis: back pain in patients with hemodyalisis by catheter related infection].
The overall incidence of vertebral osteomyelitis is increasing due to, the increasing rates of bacteraemia due to intravascular devices. We report a patient with end-stage renal failure under hemodialysis by internal jugular catheters who started with back pain after several episodes of Staphylococcus aureus bacteraemia, and whose magnetic resonance imaging was showed signs suggestive of spondylodiscitis. Other 4 similar cases from our service have been analysed, thereby we can conclude the most effective treatment of vertebral osteomyelitis and/or epidural abscess is premature diagnosis of these pathologies. Magnetic resonance imaging is the most sensitive radiologic technique whom we have. Treatment of vertebral osteomyelitis must be preceded by a correct bacteriological diagnosis. Surgery plays a central role in the successful treatment and should be performed as soon as neurological problems are apparent.
Valero
R
R
Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander.
Castañeda
O
O
de Francisco
A L M
AL
Piñera
C
C
Rodrigo
E
E
Arias
M
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001416:Back Pain / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D016470:Bacteremia / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology; D020802:Epidural Abscess / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006435:Renal Dialysis / Q000009:adverse effects*; D013122:Spinal Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013904:Thoracic Vertebrae; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents