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A clustering of epidural abscesses in chronic hemodialysis patients: risks of salvaging access catheters in cases of infection. J Am Soc Nephrol 1996 Oct;7(10):2264-7

Date

10/01/1996

Pubmed ID

8915989

DOI

10.1681/ASN.V7102264

Scopus ID

2-s2.0-0030393385 (requires institutional sign-in at Scopus site)   110 Citations

Abstract

The objective of this study was to investigate factors that might increase the risk of epidural abscesses in hemodialysis patients. The charts of all hemodialysis patients presenting with an epidural abscess over a period of 5 yr at Duke University Hospital and the Durham Veterans Administration Medical Center were reviewed for patient demographics, months on dialysis, vascular access, recently treated infections, signs and symptoms at presentation, and results of any surgical intervention. Ten patients developed an epidural abscess during a 5-yr period. Severe, debilitating back pain was the only consistent initial complaint. Eight patients had dual-lumen intravenous catheters for hemodialysis access, and five patients had or were receiving parenteral antibiotics for catheter salvage. There were no consistent physical, clinical, or laboratory findings. Surgical drainage of the abscess with removal of the hemodialysis catheters and parenteral antibiotics were required for cure in six patients. It was concluded that attempts at catheter salvage with parenteral antibiotics has significant risks for complications. Hemodialysis patients with recently treated or ongoing bacteremia who complain about severe and debilitating back pain with or without neurologic findings should raise the suspicion of an occult epidural abscess.

Author List

Kovalik EC, Raymond JR, Albers FJ, Berkoben M, Butterly DW, Montella B, Conlon PJ

Author

John R. Raymond MD President, CEO, Professor in the President department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Abscess
Aged
Aged, 80 and over
Catheterization
Cluster Analysis
Epidural Space
Equipment Contamination
Female
Humans
Male
Middle Aged
Radiography
Renal Dialysis
Risk Factors
Spinal Diseases
Time Factors