Sospecha clínica de osteomielitis vertebral: dolor de espalda en los pacientes con infección asociada al catéter de hemodiálisis

The overall incidence of vertebral osteomyelitis is increasing due to, the increasing rates of bacteraemia due to intravascular devices. We report a patient with end-stage renal failure under hemodialysis by internal jugular catheters who started with back pain after several episodes of Staphylococcus aureus bacteraemia, and whose magnetic resonance imaging was showed signs suggestive of spondylodiscitis. Other 4 similar cases from our service have been analysed, thereby we can conclude the most effective treatment of vertebral osteomyelitis and/or epidural abscess is premature diagnosis of these pathologies. Magnetic resonance imaging is the most sensitive radiologic technique whom we have. Treatment of vertebral osteomyelitis must be preceded by a correct bacteriological diagnosis. Surgery plays a central role in the successful treatment and should be performed as soon as neurological problems are apparent.