Spondylodiscitis in a patient on chronic hemodialysis

Afshar, Masoud; Reilly, Robert F.

doi:10.1038/nrneph.2011.105

Cited by 11 publications

(12 citation statements)

References 25 publications

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“… 3–5 Urinary tract infection and intra-abdominal infection are also risk factors for infective spondylodiscitis from Gram-negative bacteria following contiguous spread of the pathogen. 5 , 6 …”

Section: Discussionmentioning

confidence: 99%

“…Patients in our study might have had insidious onset of back pain that took months from initial symptoms until diagnosis, in accordance with previous reports. 6 , 11 , 12 Only one study reported that fever was the most frequent initial presentation, but almost all patients in that study eventually developed back pain during hospitalization. 7 …”

Section: Discussionmentioning

confidence: 99%

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Infective spondylodiscitis in patients on maintenance hemodialysis: a case series

Hsu

Kao

et al. 2016

Renal Failure

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Infective spondylodiscitis is a rare disease. This case review describes the clinical course, risk factors, and outcomes of adult patients on maintenance hemodialysis who presented with infective spondylodiscitis at a single medical center in Taiwan. There were 18 cases (mean age: 64.9 ± 10.8 years) over more than 10 years. Analysis of underlying diseases indicated that 50% of patients had diabetes, 55.6% had hypertension, 55.6% had coronary artery disease, 22.2% had congestive heart failure, 22.2% had a cerebral vascular accident, 16.7% had liver cirrhosis, and 11.1% had malignancies. Sixty-one percent of patients had a degenerative spinal disease and the most common symptom was back pain (83.3%). A total of 38.9% of patients had leukocytosis, 99.4% had elevated levels of C-reactive protein, 78.6% had elevated erythrocyte sedimentation rates, and 55.6% had elevated levels of alkaline phosphatase. The average hemodialysis duration was 72.8 ± 87.5 months, and 8 patients (44.4%) started hemodialysis within 1 year prior to infective spondylodiscitis. Four patients (22.2%) had vascular access infection-associated spondylodiscitis. The lumbar region was the most common location of infection (77.8%), 44.4% of patients developed abscesses, and Staphylococci were the most common pathogen (38.9%). The mortality rate was 16.7%, all due to sepsis. Thirty-three percent of the survivors had recurrent infective spondylodiscitis within 1 year. Infective spondylodiscitis should be considered in hemodialysis patients who present with prolonged back pain with or without fever. Non-contrast MRI is an appropriate diagnostic tool for this condition. Vascular access infection increases the risk for infective spondylodiscitis in hemodialysis patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infective spondylodiscitis in patients on maintenance hemodialysis: a case series

Hsu

Kao

et al. 2016

Renal Failure

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“…Known predisposing risk factors include previous spine surgery, a distant infectious focus, diabetes mellitus, advanced age, intravenous drug use, HIV infection, immunosuppression, oncologic history, renal failure, rheumatological diseases, and liver cirrhosis [11][12][13].…”

Section: Epidemiologymentioning

confidence: 99%

Spinal infection: state of the art and management algorithm

2013

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“…Both bacterial and fungal infections can occur. Reports are few 1 – 6. We highlight such a case in a patient with diabetes, which resulted in death and highlight the use of MRI in diagnosis.…”

Section: Introductionmentioning

confidence: 83%

Low back pain in a diabetic on chronic haemodialysis: pyogenic spondylodiscitis

et al. 2014

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Spondylodiscitis of the lumbar spine is described in a 67-year-old-man receiving chronic haemodialysis via a central venous catheter for diabetic nephropathy. He also had a forearm arteriovenous fistula created 1 month earlier. Clinical, MRI and surgical findings are described. The patient died despite spinal surgery and 1 month of antibiotic therapy from suspected pulmonary embolism. Early recognition by MRI or other imaging technique, prompt antibiotic therapy and often surgery are necessary for a successful outcome in this increasingly recognised complication in patients on chronic haemodialysis. Diabetes mellitus may be an added risk factor.

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Spondylodiscitis in a patient on chronic hemodialysis

Abstract: Antibiotic therapy with intravenous cefazolin for 6 weeks and oral minocycline for 2 weeks.

Cited by 11 publications

References 25 publications

Infective spondylodiscitis in patients on maintenance hemodialysis: a case series

Infective spondylodiscitis in patients on maintenance hemodialysis: a case series

Spinal infection: state of the art and management algorithm

Low back pain in a diabetic on chronic haemodialysis: pyogenic spondylodiscitis

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