Espondilodiscitis en hemodiálisis. Papel de enfermería en la sospecha precoz

Abstract

Spondylodiscitis (ED) or vertebral osteomyelitis (OM), indicates an inflammatory process, generally infectious, of the intervertebral space and adjacent vertebral bodies¹. It represents between 2 and 7% of cases of bone infection, with a higher incidence in adults between 60 and 70 years old^2,3,4. Staphylococcal infection is very common in haemodialysis patients, with Staphylococcus aureus bacteraemia being an entity with significant morbidity. The most frequent origin of this bacteremia is indwelling vascular accesses and central venous catheters (it is estimated that 1.5 to 5.5 episodes occur every 1000 days/catheter), of which 1.3 % will develop this type of infection at some point, although the frequency is three times higher with the use of a central catheter than with an arteriovenous fistula (AVF)^5,6,7. Diagnosis is often difficult due to the non-specific nature of the symptoms and the frequency of back pain in the general population⁸. In this article we present the case of a patient with S. aureus bacteremia who suffered a secondary vertebral abscess and whose main symptom was back pain, referring this symptom to nursing as the first instance. Our objective is that nurses are aware of this process in order to be able to identify the symptoms early on.