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[导管相关感染导致血液透析患者背痛:椎体骨髓炎的临床疑似情况]

[Clinical suspicion of vertebral osteomielitis: back pain in patients with hemodyalisis by catheter related infection].

作者信息

Valero R, Castañeda O, de Francisco A L M, Piñera C, Rodrigo E, Arias M

机构信息

Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander.

出版信息

Nefrologia. 2004;24(6):583-8.

Abstract

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.

摘要

由于血管内装置导致的菌血症发生率增加,椎体骨髓炎的总体发病率正在上升。我们报告了一名通过颈内静脉导管进行血液透析的终末期肾衰竭患者,该患者在多次金黄色葡萄球菌菌血症发作后开始出现背痛,其磁共振成像显示出提示脊椎椎间盘炎的迹象。我们分析了来自我们科室的其他4例类似病例,因此我们可以得出结论,椎体骨髓炎和/或硬膜外脓肿最有效的治疗方法是对这些病症进行早期诊断。磁共振成像是我们拥有的最敏感的放射学技术。椎体骨髓炎的治疗必须先进行正确的细菌学诊断。手术在成功治疗中起着核心作用,一旦出现神经问题就应立即进行。

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