1998 Volume 31 Issue 1 Pages 63-67
We describe two patients who developed pyogenic vertebral osteomyelitis while on maintenance hemodialysis for end-stage renal failure due to chronic glomerulonephritis.
One patient, a 62-year-old man, suffered from a shunt infection which was successfully treated with antibiotics after 12 years on hemodialysis. Two months later he was admitted to our hospital complaining of lumbago and fever. His symptoms did not respond to medication with antibiotics. Half a year later he was diagnosed as having pyogenic vertebral osteomyelitis and a surgical drainage was performed. A culture of the drained specimen yielded Staphylococcus epidermidis.
The other patient, a 67-year-old man, complained of fever one month after the start of hemodialysis using a double lumen catheter. The blood culture yielded MRSA, which disappeared from a subsequent blood culture after treatment with antibiotics. However, five months later, the patient complained of lumbago and two months after that he was diagnosed as having pyogenic vertebral osteomyelitis. A needle vertebral biopsy was taken and the culture of the biopsy specimen yielded MRSA. His back pain abated after therapy with intravenous vancomycin for 3 months.
