Abstract
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.
MeSH terms
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Aged
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Diabetes Mellitus, Type 2 / diagnosis
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Diabetes Mellitus, Type 2 / therapy
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Diabetic Nephropathies / diagnosis
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Diabetic Nephropathies / therapy*
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Discitis / diagnosis*
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Discitis / surgery
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Empyema / diagnosis*
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Empyema / therapy
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Fatal Outcome
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Humans
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Kidney Failure, Chronic / diagnosis
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Kidney Failure, Chronic / therapy*
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Low Back Pain / diagnosis
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Low Back Pain / etiology
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Lumbar Vertebrae
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Magnetic Resonance Imaging / methods
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Male
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Postoperative Complications / physiopathology
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Pulmonary Edema / diagnosis*
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Pulmonary Edema / therapy
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Renal Dialysis / adverse effects
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Renal Dialysis / methods*
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Severity of Illness Index
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Spinal Fusion / adverse effects
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Spinal Fusion / methods