[Vertebral tuberculosis in a chronic hemodialysis patient with polycystic kidney disease]

We report a case of vertebral tuberculosis in a female patient with polycystic kidney disease (PKD) who had been treated with maintenance hemodialysis for six years. Diagnosis of lumbar bacillary spondylitis was particularly difficult, owing to proximity of polycystic kidneys and spine. After removal of one kidney in which no bacterial focus was found, pain and inflammation persisted. Two months later CT scan and RMN evidence of 4th lumbar vertebral lysis led to performing open vertebral biopsy. Tuberculous lesions were found on this material and antibacillary treatment was begun. This case illustrates the difficulty of diagnosing vertebral tuberculosis in dialysis patients, especially in those with PKD.