We treated four cases of pyogenic spondylitis in patients with hemodialysis over the last two years. All patients were affected at the lumber spine. Three cases were caused by MRSA, MRSE and Peptostoreptococcus micros, while the fourth patient affected by unknown organisms. Only one patient was treated surgically, but this patient eventually died due to postoperative metabolic acidosis. One of the conservatively treated patients died of acute heart failure. The others were treated successfully and followed up at our outpatient clinic. Patients who receive hemodialysis are compromised hosts, and suffer poor genelal condition and pathological disorders in the bone and joints. Spondylitis should be diagnosed carefully because of destructive spondyloarthropathy (DSA), and the patient's appropriate treatment should be selected based on local findings and general condition.
