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Low back pain in a diabetic on chronic haemodialysis: pyogenic spondylodiscitis
Kanterpersad Ramcharan1, Liane Conyette, Boris Mohammed
1Department of Medicine, San Fernando Teaching Hospital, San Fernando, Trinidad and Tobago.
Abstract:
Spondylodiscitis of the lumbar spine is described in a 67-year-old-man receiving chronic haemodialysis via a central venous catheter for diabetic nephropathy. He also had a forearm arteriovenous fistula created 1 month earlier. Clinical, MRI and surgical findings are described. The patient died despite spinal surgery and 1 month of antibiotic therapy from suspected pulmonary embolism. Early recognition by MRI or other imaging technique, prompt antibiotic therapy and often surgery are necessary for a successful outcome in this increasingly recognised complication in patients on chronic haemodialysis. Diabetes mellitus may be an added risk factor.
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