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

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 desp...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2014-04, Vol.2014, p.bcr2014204128
Main Authors: Ramcharan, Kanterpersad, Conyette, Liane, Mohammed, Boris, Narine, Ravi
Format: Article
Language:English
Subjects:
Aged
Analgesics
Antibiotics
Back pain
Degenerative disc disease
Diabetes
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - therapy
Diabetic Nephropathies - diagnosis
Diabetic Nephropathies - therapy
Discitis - diagnosis
Discitis - surgery
Empyema - diagnosis
Empyema - therapy
Fatal Outcome
Fistula
Fungal infections
Hemodialysis
Hemoglobin
Hepatitis
Humans
Indian sub-continent
Kidney Failure, Chronic - diagnosis
Kidney Failure, Chronic - therapy
Low Back Pain - diagnosis
Low Back Pain - etiology
Lumbar Vertebrae
Magnetic Resonance Imaging - methods
Male
Patients
Postoperative Complications - physiopathology
Proteins
Pulmonary Edema - diagnosis
Pulmonary Edema - therapy
Reminder of Important Clinical Lesson
Renal Dialysis - adverse effects
Renal Dialysis - methods
Severity of Illness Index
South/Central America
Spinal Fusion - adverse effects
Spinal Fusion - methods
Tuberculosis
Venous access
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2014-204128