Diagnóstico y manejo terapéutico de espondilodiscitis en pacientes nefrópatas en hemodiálisis

Abstract

Spondylodiscitis is an infectious pathology of the intervertebral discs, which arises as a result of hematogenous dissemination or direct inoculation of pathogenic agents such as S. aureus, predominantly in patients with renal failure undergoing hemodialysis, who undergo puncture processes for placement of dialysis catheters. It does not occur frequently and requires the timely use of diagnostic methods for its correct approach, for which the following literature review is performed. OBJECTIVE: To describe the diagnosis and therapeutic management of spondylodiscitis in nephropathic patients on hemodialysis by reviewing scientific articles of the last five years for a permanent updating of health professionals. MATERIALS AND METHODS: the search for articles was carried out through official medical pages with scientific evidence: PubMed, Elsevier, Google Scholar, duly located in Scimago and World Ranking of quartile I and II. CONCLUSIONS: Spondylodiscitis is an infrequent and underdiagnosed disease in nephropathic patients on dialysis therapy, which increases the morbimortality rate. The diagnostic and therapeutic gold standard is magnetic resonance imaging and vertebral culture; however, current studies mention the endoscopic debridement approach. Therapeutic management is based on the identification of the causal agent and the use of broad-spectrum antibiotics such as: Clindamycin+ciprofloxacin or cefotaxime + flucloxacillin, although there is evidence of a new antibiotic called dalbavancin.