A 57-year-old male with a history of arterial hypertension and dyslipidemia, presented with ischemic heart disease and acute lower myocardial infarction in 2004, peripheral arteriopathy with bilateral occlusion by limb-vascularization that required a left fallopian tube in 2006, suffered acute ischemia by urgent in 2010.
She has been on hemodialysis since December 2010 for chronic renal failure possibly secondary to nephroangiopathy.
After failure of left radiolabelled AVF, a left jugular temporary catheter was placed at the end of August 2013, which was dysfunctional from the beginning but maintained until the use of new left atrial fibrillation hVI.
One month after placement of the catheter, the patient reported postural low back pain to the ward punctually, although the patient himself thought that some effort had been made.
After catheter removal (43 days after insertion), several subsequent sessions showed general malaise and fever, bacteriological control of the monitor was performed which is negative and vancomycin 1 g was administered empirically, along with a stable antipyretic.
Subsequently, he reported a new very intense low back pain that barely allowed him to walk, came to the emergency room up to four times in which after examination, radiography and abdominal ultrasound always diagnosed mechanical low back pain.
Given the deterioration of the general state and after checking for analytical alterations (increased C-reactive protein and erythrocyte sedimentation rate) he was admitted to the internal medicine unit for study.
After positive microbiological results for S. aureus antibiotic treatment was initiated with cloxacillin.
After performing a nuclear magnetic resonance (NMR), a diagnosis of Dilodyscitis D10-D11 is made, which is associated with an abscess for not conditioning a compromise of nerve structures MRI.
Analgesic treatment was initiated with first-level drugs associated with transdermal opioids, with progressive dose titration throughout the hospital stay and acceptable pain control.
The patient remains afflicted throughout his admission, with progressive decrease of acute phase reactants and negativization of hemocultives.
It comprises five weeks of directed intravenous antibiotic treatment, switching to ambulatory oral therapy and was discharged.
At this time, the patient remains stable without additional intradialytic symptomatology with analgesia controlled by the patient and waiting for a new control MRI.
