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KMID : 1235920120040020085
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Medical Journal of Catholoc University of Daegu
2012 Volume.4 No. 2 p.85 ~ p.90
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Epidural Abscess by Catheter-Related Bacteremia in a Hemodialysis Patient
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Lee In-Hee
Park Hyun-Jin
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Abstract
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We report here a case of spinal epidural abscess associated with catheter-related bacteremia in a hemodialysis patient.
A 51-year-old man with end-stage renal disease from chronic glomerulonephritis presented to the nephrology clinic with a fever and lower back pain. He had been on maintenance hemodialysis three times per week through a right internal jugular (IJ) permcath since 8 weeks prior to the admission. Spinal magnetic resonance imaging revealed a spondylitis of 4th. lumbar vertebra (L) with epidural abscess. He was treated with intravenous vancomycin, antibiotic lock solutions, and decompression of the abscess. Cultures of blood, aspirates, and tip of the permcath all grew oxacillin-sensitive Staphylococcus aureus. Thereafter, antibiotics was switched to intravenous cefazolin and he was dialyzed using an uncuffed catheter after removal of the IJ permcath. Progressed spondylitis with destruction of the L4 end plate was noted on follow-up lumbar computed tomography scan. He underwent anterior interbody fusion of L4-L5. Postoperatively, the lower back pain and leg weakness gradually improved without clinical evidence of residual bacteremia.
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KEYWORD
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Epidural abscess, Catheter-related bacteremia, Hemodialysis
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