A case of lumbar vertebral osteomyelitis and iliopsoas muscle abscess as metastatic infectious complications in a hemodialysis patient with a hemodialysis catheter

Abstract

We report a case of lumbar vertebral osteomyelitis and iliopsoas muscle abscess in a hemodialysis patient with a hemodialysis catheter. A male patient in his 80s was admitted to another hospital for uremia due to end-stage renal disease. A non-cuffed hemodialysis catheter was inserted from the right femoral vein and hemodialysis was initiated. On the 24th day after catheter insertion, the patient developed jaundice and was transferred to our hospital for management. During his hospital stay, he was diagnosed with catheter-related blood stream infection (CRBSI), lumbar vertebral osteomyelitis and iliopsoas muscle abscess as metastatic infectious complications caused by Enterococcus faecalis. We treated the patient with intravenous ampicillin (ABPC) and continuous hemodiafiltration, but he died from septic shock 9 days after admission. In cases with CRBSI arising during hemodialysis in patients with hemodialysis catheters, CRBSI should be diagnosed early and adequate therapy started to prevent critical metastatic infectious complications.