Eisenberg B, Murphy G, Tzamaloukas A H
Nuclear Medicine Service, Veterans Affairs Medical Center, Albuquerque, New Mexico 87108.
Am J Physiol Imaging. 1991;6(1):26-8.
Sternal osteomyelitis complicating infection of vascular access for hemodialysis is exceedingly rare and presents serious diagnostic and therapeutic difficulties. Two hemodialysis patients with sternal osteomyelitis following vascular access infection are reported. Factors favoring sternal location of the infection included previous chest trauma in the first patient and difficult insertion of a dialysis subclavian catheter in the second patient. Indium oxine, gallium, and three-way bone scans were instrumental in establishing diagnosis and in documenting cure by prolonged antibiotic courses. Sternal scans should be performed in dialysis patients with vascular access infections and signs of sternal disease.
并发血液透析血管通路感染的胸骨骨髓炎极为罕见，且存在严重的诊断和治疗难题。本文报告了两例血液透析患者在血管通路感染后发生胸骨骨髓炎的病例。感染易发生于胸骨部位的因素包括：首例患者既往有胸部外伤史，第二例患者的透析锁骨下导管插入困难。铟氧喹、镓及三相骨扫描有助于确诊，并通过长期抗生素疗程记录治愈情况。对于有血管通路感染及胸骨疾病体征的透析患者，应进行胸骨扫描。
