The Japanese Journal of Clinical Dialysis Vol.32 No.2(6-3)

Theme Fatal infections of elderly and super-elderly dialysis patients
Title Lumbar vertebral osteomyelitis and iliopsoas muscle abscess due to MRSA infection
Publish Date 2016/02
Author Takashi Harada Nagasaki Kidney Hospital
Author Osamu Sasaki Nagasaki Kidney Hospital
Author Hiroshi Ichinose Nagasaki Kidney Hospital
Author Kenji Sawase Nagasaki Kidney Hospital
Author Satoshi Funakoshi Nagasaki Kidney Hospital
[ Summary ] Herein, we present a case of lumbar vertebral osteomyelitis and iliopsoas muscle abscess due to methicillin-resistant Staphylococcus aureus (MRSA) infection in a patient undergoing hemodialysis and describe the disease entities, diagnoses, and treatment of these diseases. Delayed treatment of sepsis induced by catheter-related blood stream infection is easily complicated with lumbar vertebral osteomyelitis and iliopsoas muscle abscess. Magnetic resonance imaging (MRI) is needed for the early diagnosis of these diseases. T2-weighted MRI examination showed high-signal intensity in the abscess. Most bacteria infecting the blood stream are gram-positive Staphylococcus, generally MRSA. Therefore, the incidence of MRSA-related osteomyelitis and iliopsoas muscle abscess is high. Treatment of blood stream infection with anti-MRSA antibiotics is highly recommended.
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